Strahlentherapie und Onkologie最新文献

{"title":"Hypofractionated and conventionally fractionated radiotherapy for synchronous bilateral breast cancer: clinical and dosimetric outcomes.","authors":"Bahar Cepni, Line Hoeltgen, David Neugebauer, Vania Batista, Nathalie Arians, Jakob Liermann, Lars Wessel, Maria Vinsensia, Semi Harrabi, Hanna Waldsperger, Thomas Tessonnier, Juliane Hörner-Rieber, Jürgen Debus, Eva Meixner","doi":"10.1007/s00066-026-02558-5","DOIUrl":"https://doi.org/10.1007/s00066-026-02558-5","url":null,"abstract":"<p><strong>Background: </strong>The irradiation of both breasts poses complex technical challenges. The overlapping treatment fields and large target volumes make dosimetry challenging, while data for hypofractionated regimens in this setting are limited.</p><p><strong>Methods: </strong>Bilateral breast cancer patients treated with moderately hypofractionated and conventionally fractionated radiotherapy were identified to evaluate dosimetric parameters, toxicity, and oncologic outcomes.</p><p><strong>Results: </strong>Seventy patients treated with a median dose of 50.4 Gy in 28 fractions or 40.05 Gy in 15 fractions using 3D-CRT, IMRT, VMAT, or tomotherapy were identified. With a median follow-up of 45.3 months, the 1‑ and 5‑year overall survival rates were 96.1% and 88.7%, and the local control rates were 100% and 92.5%, respectively. The median lung and heart doses were 8.4 and 4.0 Gy for conventional fractionation and 7.6 and 3.1 Gy for hypofractionation, respectively. With conventional fractionation, acute toxicity (≥ grade 3) occurred in 11% of patients (skin), and late toxicity occurred in 4% (skin and cardiac). With hypofractionation, acute toxicity (≥ grade 3) occurred in 8% (skin); no late grade ≥ 3 toxicity was observed. Even though late skin toxicity was more frequent with conventional fractionation, this did not reach statistical significance (p = 0.056). Regarding RT techniques, only the use of helical tomotherapy was associated with higher incidences of acute ≥ grade 3 skin toxicity (p = 0.029).</p><p><strong>Conclusion: </strong>Our long-term findings support the use of moderately hypofractionated RT with VMAT as a safe option for bilateral whole-breast irradiation for synchronous bilateral breast cancer, demonstrating favorable outcomes. However, prospective data are still needed, especially for nodal and bilateral chest wall irradiation involving implants.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148218997","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":"DEGRO 2026 Abstractband.","authors":"","doi":"10.1007/s00066-026-02529-w","DOIUrl":"https://doi.org/10.1007/s00066-026-02529-w","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199935","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":"Thyroid dose guidance in elective supraclavicular breast radiotherapy: a national survey of practice patterns in Switzerland.","authors":"M S Koch, D R Zwahlen, A Clivio, M Bendahman, D Benzaquen, M Betz, P Canino, D Correia, B De Bari, O Fargier Bochaton, T Finazzi, M Gau, G Gruber, R Gräter, G Henke, E Herrmann, K Khanfir, R Krcek, K Lössl, T Mader, O Matzinger, L Negretti, C Panje, N Péguret, L Plasswilm, P Tsoutsou, F Zimmermann, C Oehler","doi":"10.1007/s00066-026-02557-6","DOIUrl":"https://doi.org/10.1007/s00066-026-02557-6","url":null,"abstract":"<p><strong>Background: </strong>Supraclavicular fossa (SCF) irradiation is integral to adjuvant radiotherapy (RT) for node-positive breast cancer. Due to anatomical proximity, the thyroid gland is frequently exposed, leading to hypothyroidism in approximately 20-40% of long-term survivors. Despite robust dose-response evidence, thyroid management remains inconsistent and breast cancer-specific dose guidance is lacking. This nationwide survey evaluated current practice patterns regarding thyroid delineation, SCF contouring, and thyroid dose guidance during elective SCF irradiation in Switzerland.</p><p><strong>Methods: </strong>A structured electronic questionnaire was distributed between May and November 2025 to all 30 Swiss radiation oncology centers treating breast cancer. Institutional characteristics, thyroid contouring practices, SCF target delineation, and applied thyroid dose guidance were assessed. Analyses were descriptive only.</p><p><strong>Results: </strong>Thirty-three responses from 25 of 30 centers (83%), including all university hospitals, were analyzed. Modern RT techniques were widely implemented (VMAT 79%, IMRT 15%). Routine thyroid contouring was reported by 91% of respondents, of which 94% used AI-assisted tools. However, only 55% applied explicit thyroid dose guidance. Reported mean thyroid dose (D_mean) thresholds ranged from 12 to 35 Gy and clustered at 13.5-15 Gy, 20-21 Gy, and 30-32 Gy. Excluding ALARA (\"as low as reasonably achievable\") responses, the median D_mean guidance was 21 Gy (IQR 16-30 Gy). SCF delineation varied substantially, particularly regarding superior and medial margins, and 64% reported CTV/PTV cropping to reduce thyroid dose.</p><p><strong>Conclusions: </strong>Despite strong dose-response evidence and widespread availability of advanced RT techniques, thyroid protection during elective SCF irradiation remains inconsistently implemented. These findings reveal a gap between evidence and practice and support the development of harmonized, breast cancer-specific recommendations, including routine thyroid delineation, anatomy-based SCF contouring, and explicit, oncologically safe dose guidance-particularly D_mean targets of ≤ 13.5 Gy, with ≤20-21 Gy as a pragmatic upper limit-to reduce radiation-induced hypothyroidism without compromising cancer control.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158253","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":"[WOLVERINE, a meta-analysis on stereotactic radiotherapy of oligometastases in prostate cancer].","authors":"Jürgen Dunst","doi":"10.1007/s00066-026-02520-5","DOIUrl":"10.1007/s00066-026-02520-5","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"683-684"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582386","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":"Gender role in radiotherapy: psychosocial differences between males and females during cancer care : Single-centre report on adult and paediatric oncological patients.","authors":"L Dinapoli, N Dinapoli, E Marconi, S Chiesa, C Mazzarella, M Massaccesi, S Longo, F Marazzi, V Masiello, R Autorino, V De Luca, L Boldrini, G Chiloiro, S Manfrida, A Mastronuzzi, E Meldolesi, L Sani, V Frascino, F Miccichè, V Valentini, L Tagliaferri, G F Colloca, D P R Chieffo, M A Gambacorta","doi":"10.1007/s00066-025-02379-y","DOIUrl":"10.1007/s00066-025-02379-y","url":null,"abstract":"<p><strong>Purpose: </strong>Recent studies indicate that gender plays a role in influencing the side effects and outcomes of radiotherapy (RT), thus highlighting the importance of gender-specific clinical approaches. However, there remains a knowledge gap regarding potential gender differences in the domain of psychosocial profiles during RT. This retrospective analysis examines the psychosocial impact of RT on a cohort of adult and paediatric patients in Italy who received psycho-oncological support during RT from January 2020 to April 2024.</p><p><strong>Methods: </strong>Medical charts of a total of 750 adult (418 females and 332 males) and 145 paediatric patients (78 male and 67 females) were reviewed. In our radiation oncology department, two psycho-oncological pathways are available for adults: 1) dedicated pathways for patients with head and neck, brain, or rectal and anal cancers, where psychological support is provided automatically; and 2) support for other patients upon request or clinical recommendation. For paediatric patients, psychoeducational/psychotherapeutic interventions tailored to the needs of patients/caregivers are initiated at the start of RT to ensure compliance and promote psychological wellbeing.</p><p><strong>Results: </strong>Female adult patients reported higher levels of distress, anxiety, and depression than males, with significant predictors including gender and previous psychological disturbances. Notably, patients undergoing RT with palliative or local-control intent exhibited increased anxiety and depression. In contrast, no significant gender differences in psychosocial distress were observed among paediatric patients. Both genders received consistent psychological support, and familial trauma and RT intent did not significantly affect their scores.</p><p><strong>Conclusion: </strong>In this retrospective analysis, gender is a crucial predictor of psychosocial outcomes in adults undergoing RT, with females experiencing higher distress levels. Prior mental health stability appears protective against anxiety and depression. In paediatric patients, interventions remain effective across genders. Early psychological assessments are essential for both groups to identify patients at risk and enhance coping strategies.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"635-646"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568245","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":"The underestimated role of pioneering women in radiation oncology: lessons from the past for today's practice.","authors":"Michael Oertel, Vina Zielonka, Uwe Busch, Uwe Haverkamp, Maike Trommer, Angela Besserer, Franziska Eckert, Jilada Wilhelm, Rita Engenhart-Cabillic, Hans-Georg Hofer, Hans Theodor Eich, Oliver Micke","doi":"10.1007/s00066-025-02386-z","DOIUrl":"10.1007/s00066-025-02386-z","url":null,"abstract":"<p><strong>Purpose: </strong>The early history of radiation and radiation oncology is imprinted by innovative pioneers both in physics and clinical application. Despite the remarkable example of Marie Curie, the contributions of female physicians, physicists, and radiation therapists in the first years of radiation practice are often forgotten or neglected. This analysis aims at a comprehensive review of pivotal female pioneers in the field of radiation oncology and summarizes current and future challenges with regard to gender equality in the radiation oncology workforce.</p><p><strong>Methods: </strong>The History and Women in Radiation Oncology working groups of the German Society for Radiation Oncology (DEGRO) conducted a selective literature research on Marie Kundt, Marietta Blau, Elisabeth Fleischmann, and Anna Hamann, who were chosen as representative examples of female pioneers. Medical and sociological analyses were selected to illustrate the present situation and point out future challenges.</p><p><strong>Results: </strong>The review illustrates that women in radiation oncology in the late 19th/early 20th century were hindered in enrolling in educational institutions and in pursuing an equal (and recognized) professional career; they were also subject to discrimination. Thus, great dedication and personal sacrifices were needed to succeed. Despite this, significant contributions were made by women, and the four discussed colleagues contributed to or even enabled the formation of critical aspects of modern radiation oncology, such as X‑ray imaging, radiation physics, different treatment techniques, and the profession of radiation technicians. Lacking adequate radiation protection at the time, their inspirational spirit came at a significant cost, and three of the four presented pioneers (MB, EF, and AH) succumbed to irradiation-induced cancers. Today, modern analyses still show that female professionals tend to drop out during their career before professorship or head of department positions and are therefore underrepresented in these career stages.</p><p><strong>Conclusion: </strong>The history of women in radiation oncology is marked by discrimination and great personal and professional sacrifices. Despite these challenges, female pioneers contributed to the development of modern radiation oncology in a significant way. Today, gender disparities in the workforce persist and constitute challenges which need to be addressed to enable equal access to leading positions.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"585-594"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574004","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":"Correction to: DEGRO statement on the KEYNOTE-689 trial: Perioperative immunotherapy in combination with adjuvant (chemo-)radiotherapy for resectable locally advanced head and neck cancers.","authors":"Sören Schnellhardt, Simon Böke, Silke Tribius, Mechthild Krause, Marlen Haderlein, Alexander Rühle, Christoph Süß, Annett Linge, Markus Hecht, Panagiotis Balermpas","doi":"10.1007/s00066-026-02534-z","DOIUrl":"10.1007/s00066-026-02534-z","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"682"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781674","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":"From radiation beams to digital streams: social media engagement of German radiotherapy facilities.","authors":"Fatima Zahra Ouahmane, Ann-Katrin Exeli, Linda Agolli, Daniel Habermehl","doi":"10.1007/s00066-025-02439-3","DOIUrl":"10.1007/s00066-025-02439-3","url":null,"abstract":"<p><strong>Purpose: </strong>Social media (SoMe) increasingly impacts communication in the healthcare sector. Despite its growing relevance, there is limited research on how these institutions utilize SoMe for their purposes. We conducted a descriptive analysis with the aim of evaluating the presence, frequency, and content focus of SoMe activities of German radiotherapy institutions.</p><p><strong>Methods: </strong>The study analyzed SoMe activities of German radiotherapy institutions. Institutions were identified using selected keywords, and their presence on LinkedIn, X, Instagram, YouTube, and Facebook was recorded. The analysis assessed platform activity, posting frequency, content categories, and follower distribution, distinguishing between hospital and medical care center types, over a 6-month period. Contents were categorized into six themes, including clinical updates, research, events, job postings, education, and team news.</p><p><strong>Results: </strong>The analysis showed that a total of 24% of German radiotherapy institutions had active social media profiles, with university and larger hospitals being more active than smaller practices or medical care centers (MVZ, medizinische Versorgungszentren). The majority of content focused on events and announcements (34%), followed by health awareness and education (19%), research findings (16%), and team news (15%). Job postings (8%) and clinical updates (7%) were less frequently shared. Instagram has the largest follower share (46%), but LinkedIn remains the most active platform, accounting for 86% of posts.</p><p><strong>Conclusion: </strong>LinkedIn emerges as the leading platform for institutional presence, engagement, and content distribution, with a strong focus on events, scientific studies, and team news; while Instagram leads in follower count, LinkedIn dominates in posting activity.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"627-634"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660228","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":"Gender disparities in historical context, workforce structure, and decision-making.","authors":"Lisa Weissmann, Katharina Hintelmann, Stefanie Corradini","doi":"10.1007/s00066-026-02538-9","DOIUrl":"10.1007/s00066-026-02538-9","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":"202 6","pages":"581-584"},"PeriodicalIF":2.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035285","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":"Prognostic parameters for local control and survival after radiotherapy of stabilized bone metastases.","authors":"Vlatko Potkrajcic, Dominik Wahl, Sandra Frantz, Elgin Hoffmann, David Baumann, Kerstin Clasen, Verena Gassenmaier, Tatevik Mrva-Ghukasyan, Maximilian Niyazi, Frank Paulsen, Frank Traub, Franziska Eckert","doi":"10.1007/s00066-026-02539-8","DOIUrl":"https://doi.org/10.1007/s00066-026-02539-8","url":null,"abstract":"<p><strong>Background: </strong>Postoperative radiotherapy following surgical stabilization in patients with bone metastases is commonly recommended. The aim of the study was to validate existing prognostic scores and parameters for local control and survival in patients with bone metastases treated with surgical resection with or without radiotherapy.</p><p><strong>Methods: </strong>This retrospective single-institution study analyzed consecutive patients with bone metastases undergoing resection and/or stabilization mostly due to pathologic or impending fractures (with or without spinal compression). Additive radiotherapy was considered the standard of care. Various fractionated radiotherapy regimens have been applied; equivalent dose in 2 Gy fractions (EQD2) has been calculated to enable comparison between fractionations. Prognostic factors influencing local progression-free survival (LPFS) and overall survival (OS) were evaluated.</p><p><strong>Results: </strong>The median follow-up was 9 months (range 1-121 months). A total of 142 patients were included. Most patients underwent surgery due to pathologic (n = 86, 60.6%) or impending fracture (n = 54, 38.0%), with or without spinal compression. Most common histologies were breast (n = 30, 21.1%) and lung cancer (n = 30, 21.1%); most common metastasis locations were spine (n = 58, 40.8%), lower (n = 56, 39.4%) and upper extremities (n = 23, 16.2%). Postoperative radiotherapy was performed in 89 patients (62.7%). Location in the spine and prior irradiation were identified as poor prognostic factors for LPFS. In patients with spine metastases, improved LPFS was demonstrated in those treated with postoperative radiotherapy (2 years LPFS 96.7% ± 3.3% vs. 23.4 ± 19.0%; p = 0.003). Postoperative radiotherapy did not improve LPFS in patients with bone metastases outside the spine (p = 0.960). Better OS rates were demonstrated in patients with good performance status (ECOG) and with moderate and good prognosis according to the Tokuhashi score.</p><p><strong>Conclusion: </strong>Our real-life data revealed that a significant number of patients did not receive postoperative radiotherapy for various reasons. Established prognostic scores (Tokuhashi and ECOG score) correlate with patient survival, and their use should be encouraged to determine optimal patient treatment and to identify patients who may benefit from postoperative radiotherapy, due to their longer life expectancy. LPFS improved with postoperative radiotherapy in spinal bone metastases, but not in nonspinal metastases.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138816","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}