Strahlentherapie und Onkologie最新文献

{"title":"[First-generation TKI and simultaneous thoracic radiotherapy for EGFR-mutated metastatic Non-Small Cell Lung Cancer (NSCLC): a promising new approach?]","authors":"Korneel Hartong, Fabian Weykamp","doi":"10.1007/s00066-025-02428-6","DOIUrl":"10.1007/s00066-025-02428-6","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"973-975"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643601","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":"Advantages of 3D printed patient-individual moulds in brachytherapy for facial skin cancer.","authors":"Jörg Licher, Julia Achenbach, Janett Köhn, Markus Diefenhardt, Maximilian Fleischmann, Claus Rödel, Nikolaos Tselis, Ulla Ramm, Christian Scherf","doi":"10.1007/s00066-025-02372-5","DOIUrl":"10.1007/s00066-025-02372-5","url":null,"abstract":"<p><strong>Purpose: </strong>Facial skin cancer of 42 elderly frail patients was treated with individualised 3D-printed mould applicators for high-dose-rate (HDR) brachytherapy. The dosimetric outcome was compared to conventionally manufactured individual moulds used before.</p><p><strong>Methods: </strong>Tumour-adapted HDR brachytherapy source paths were pre-planned and dosimetrically optimised in the brachytherapy treatment planning system (TPS) using computed tomography (CT) data and considered in the design of the patient-individual moulds. Dosimetric outcome for the planning target volumes and organs at risk were statistically evaluated and compared for pre-planning, final clinical treatment planning with TG-43 formalism and retrospective tissue, material and CT density related TG-186 calculations.</p><p><strong>Results: </strong>Pre-planning allows reliable brachytherapy source paths design to achieve intended dosimetric clinical goals. The 3D-printed patient-specific moulds show a clear advantage in the dosimetric coverage of the target volume (improving D₉₀ from 98.3% to 104.3%) and the protection of the relevant organs at risk (reduction up to 30% of maximum Dose). With the 3D-printed moulds only minor deviations were observed for TG-43 and TG-186 dose recalculations of the treated plans.</p><p><strong>Conclusion: </strong>Customised 3D printed moulds offer a safe and efficient technique to treat facial skin cancer in critical locations and complex clinical situations with HDR brachytherapy. The two-step planning process results in reliable PTV dose coverage and efficient sparing of eye lenses and eyeballs. Dosimetric outcome and interfractional position reproducibility with 3D printed moulds were superior to conventionally manufactured facial moulds with respect to the clinical goals.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"940-952"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504294","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":"Use of surface tracking recordings to identify pitfalls during surface-guided radiotherapy.","authors":"G Klumpp, S Baumbach, N Wegner, P Freislederer, L Wagner, K P Aninditha, T Ellethy, M Münter","doi":"10.1007/s00066-024-02331-6","DOIUrl":"10.1007/s00066-024-02331-6","url":null,"abstract":"<p><strong>Objective: </strong>The precise daily positioning of patients during radiation therapy determines the quality of the entire treatment. To avoid additional radiation exposure from regular cone-beam CT (CBCT) scans, surface-guided radiotherapy systems (SGRT) are increasingly used. The aim of this prospective clinical study was to evaluate the advantages, feasibility, and pitfalls of SGRT using the surface tracking recorder prototype of the camera component of ExacTrac Dynamic (Brainlab AG, Munich, Germany). This system combines both surface-based imaging technology and a thermographic camera that records patients via thermal imaging to accurately measure patient geometry.</p><p><strong>Methods: </strong>The surfaces of patients with various tumor entities and therefore different regions of interest (ROIs) were recorded with the surface camera during positioning and throughout treatment. Subsequently, these surface camera datasets were analyzed to compare the accuracy of patient positioning with the current treatment standard (X-ray-based IGRT). The camera components were used only as an imaging tool and not to correct any deviations. For evaluation of typical pitfalls, errors > 5 mm for extracranial indications and > 2 mm for cranial indications were analyzed using parameters extracted from the surface recordings and the corresponding CBCT shifts.</p><p><strong>Results: </strong>In total, 162 displacement vector datasets for 130 patients were generated and evaluated. The smallest deviations were found in the head and neck regions (mean deviation 1.9 mm/0.8°). The largest mean translational deviation (4.8 mm) and mean rotational deviation (1.1°) were found in the pelvic area. In all regions, most datasets showed clinically acceptable deviations; however, large outliers were observed in some measurements, particularly longitudinally. These outliers are of special interest because they may indicate mistakes in the use of SGRT, and they were therefore analyzed separately in detail. Several reasons for the outliers were identified, and potential solutions to avoid these pitfalls are presented.</p><p><strong>Conclusion: </strong>This observational study demonstrated the advantages and pitfalls of SGRT by using the surface tracking recorder prototype of the camera component of ExacTrac Dynamic. These pitfalls can be avoided through thorough application of SGRT. This study may serve as a practical guide for clinicians already using or introducing SGRT for patient positioning.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"930-939"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772437","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":"Ceftriaxone has a neuroprotective effect in a whole-brain irradiation-induced neurotoxicity model by increasing GLT-1 and reducing oxidative stress.","authors":"Nilsu Cini, Özüm Atasoy, Yigit Uyanikgil, Gökhan Yaprak, Mümin Alper Erdoğan, Oytun Erbas","doi":"10.1007/s00066-025-02405-z","DOIUrl":"10.1007/s00066-025-02405-z","url":null,"abstract":"<p><strong>Background: </strong>Radiation-induced brain injury is a prominent side effect of whole-brain irradiation (IR) due to triggered oxidative and inflammatory processes, often resulting in severe and debilitating cognitive dysfunction and neuronal damage. The development of persistent oxidative stress results from radiation-induced reactive oxygen species. Another result is the initiation of glutamate excitotoxicity, which is closely associated with changes in glutamate levels. Elevated release or reduced glutamate uptake disrupts neuronal homeostasis, leading to oxidative stress, mitochondrial dysfunction, and neuroinflammation. The neuroprotective and antioxidant properties of ceftriaxone (CTX) have been linked to its ability to reduce glutamate excitotoxicity, inflammation, and to modulate oxidative stress.</p><p><strong>Materials and methods: </strong>Twenty-one female Wistar rats were included in the study, and 14 of them underwent whole-brain IR with a single dose of 20 Gy on day 7. Saline and CTX applications continued for 21 days. The animals were divided into three groups: group 1: normal control; group 2: IR + saline; and group 3: IR + CTX. To compare the groups, a one-way analysis of variance (ANOVA) statistical test was employed, with a significance threshold set at p < 0.05.</p><p><strong>Results: </strong>Ceftriaxone treatment had a positive impact on the results of various assessments, e.g., behavioral tests including the three-chamber sociability test, the open-field test, and passive avoidance learning. It also led to increased counts of hippocampal CA1, CA3, and Purkinje neurons as well as elevated brain levels of brain-derived neurotrophic factor (BDNF), glutamate transporter 1 (GLT-1), and superoxide dismutase (SOD) activity. Conversely, CTX reduced the glial fibrillary acidic protein (GFAP) immunostaining index as well as brain levels of malondialdehyde (MDA) and tumor necrosis factor alpha (TNF-α).</p><p><strong>Conclusion: </strong>Ceftriaxone demonstrated promising effectiveness in mitigating radiation-induced neurocognitive impairments and the deterioration of social memory capacity. This effect is achieved by reducing neuronal loss, oxidative stress, and neuroinflammation in irradiated rat brains. Furthermore, the application of CTX facilitated removal of excess glutamate from synapses, thus preventing glutamate excitotoxicity and protecting neurons from excitotoxic cell death.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"903-919"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038408","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":"Hyperglycemia is associated with poor survival in patients with brain metastases treated with radiotherapy.","authors":"Soniya Poudyal, Friederike Rothe, Seong Jeong, Nils Gleim, Peter Hambsch, Franziska Nägler, Kirsten Papsdorf, Thomas Kuhnt, Alonso Barrantes-Freer, Erdem Güresir, Sabine Klagges, Nils Henrik Nicolay, Clemens Seidel","doi":"10.1007/s00066-025-02414-y","DOIUrl":"10.1007/s00066-025-02414-y","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes mellitus (DM) is a negative prognostic factor in patients with brain metastases (BM). It is unknown whether a direct impact of serum glucose levels on survival exists. We aimed to detect a potential association of serum glucose levels before and during radiotherapy with survival in patients with BM.</p><p><strong>Methods: </strong>Patients were included in this retrospective exploratory analysis if at least three fasting and non-fasting serum glucose test results before or during treatment were available. Survival was analyzed with uni- and multivariate Cox regression concerning an association with fasting and maximum glucose levels and regarding potentially confounding dexamethasone intake.</p><p><strong>Results: </strong>A total of 62 patients with BM (15 with and 47 without DM) were included. Patients with a mean fasting glucose of more than 7.8 mmol/l (upper quartile) showed significantly shorter survival compared to patients of the lower three quartiles (hazard ratio [HR] = 2.05, p = 0.021). Further, maximum blood glucose levels of > 12.0 mmol/l (upper quartile) were associated with shorter survival (HR = 1.95, p = 0.035). In the subset of patients without DM, a trend toward worse survival in patients with higher fasting glucose levels was observed (HR = 2.54, p = 0.099). The negative association of high maximum glucose levels with survival persisted in multivariate analysis independently of steroid administration.</p><p><strong>Conclusion: </strong>Strong elevations of fasting and maximum serum glucose levels were associated with a worse prognosis in patients with BM with and without DM. This observation warrants further analysis in larger cohorts and has potential implications for clinical practice.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"920-929"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302832","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":"CyberKnife radiation therapy for malignant myopericytoma in a pediatric patient: a case report and review of the literature.","authors":"Bence Bukovszky, Júlia Vízkeleti, Levente Jánváry, Gábor Szarvas, Luca Felkai, Rita Bánusz, Edit Varga, Zoltán Sápi, Tibor Major, Monika Csóka","doi":"10.1007/s00066-025-02413-z","DOIUrl":"10.1007/s00066-025-02413-z","url":null,"abstract":"<p><strong>Background: </strong>Malignant myopericytoma is a very rare malignant soft tissue tumor which usually develops during adulthood. It has a very poor prognosis due to its aggressive nature and frequent distant metastases.</p><p><strong>Methods: </strong>In our case report, we present a 17-month-old girl with malignant myopericytoma who was successfully treated using CyberKnife (Accuray; Sunnyvale, CA, USA) stereotactic radiotherapy.</p><p><strong>Results: </strong>A rare localization of the tumor caused significant challenges during the course of treatment. Radical surgical resection was not achievable due to the tumor's location in the inner ear; therefore chemotherapy was initially given to the patient. However, due to the fast progression of the tumor during chemotherapy, we decided to use CyberKnife stereotactic radiosurgery (SRS; 5 fractions of 7 Gy) in order to prevent further invasion of the surrounding tissues. During SRS, tumor growth stopped and the tumor then gradually regressed. Since completion of treatment (currently almost 5 years) our patient has been in complete remission without any significant side effects of the radiation therapy.</p><p><strong>Conclusion: </strong>In our recent experience, systemic chemotherapy combined with CyberKnife SRS proved to be effective in a patient with a rare malignant myopericytoma.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"963-970"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302831","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":"[Less is more: dose de-escalation in early anal cancer-Clinical and functional aspects of quality of life from the PLATO-ACT4 trial].","authors":"L Völler, E Fokas, C Rödel, D Martin","doi":"10.1007/s00066-025-02430-y","DOIUrl":"10.1007/s00066-025-02430-y","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"976-978"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683197","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":"[A scoring system to determine the postoperative recurrence risk after brain metastasis resection].","authors":"Merle Sophie Corvey, Mathias Alexander Sonnhoff, Matthias Sievers","doi":"10.1007/s00066-025-02426-8","DOIUrl":"10.1007/s00066-025-02426-8","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"971-972"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584880","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":"Genomic analysis of radiosensitivity in breast cancer : Identifying pathological determinants and assessing genomic-adjusted radiation dose (GARD) for personalized dose escalation.","authors":"Pierre Loap, Irène Buvat, Alain Fourquet, Youlia Kirova, Gilles Crehange","doi":"10.1007/s00066-025-02454-4","DOIUrl":"https://doi.org/10.1007/s00066-025-02454-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Adjuvant radiotherapy improves recurrence-free survival in breast cancer, but intrinsic tumor radiosensitivity varies substantially, even within histologically similar subtypes. The radiosensitivity index (RSI), based on the expression of 10 genes, and the genomic-adjusted radiation dose (GARD) model enable personalized radiotherapy dosing. This study investigates the association between histological and molecular features and RSI, and quantifies the biological effect of radiation boost doses across conventional and hypofractionated regimens.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Transcriptomic RNA-seq data from 1284 breast cancer patients in The Cancer Genome Atlas Breast Invasive Carcinoma (TCGA-BRCA) cohort were analyzed. RSI was calculated using a rank-based model, and GARD was computed for multiple fractionation schemes, with or without integrated boosts. Univariate and multivariate linear models identified histological and molecular correlates of RSI. EPIC (estimating the proportions of immune and cancer cells) deconvolution was performed to estimate tumor purity and the immune/stromal cell composition. Analyses were restricted to samples with ≥ 50% tumor content. Independent validation was performed in the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) cohort (n = 1981), using microarray-based gene expression data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The median RSI in the TCGA cohort was 0.471 and was significantly lower in basal (p &lt; 0.001) and luminal B (p &lt; 0.001) subtypes, as well as in tumors with necrosis, inflammation, or high mitotic activity. These associations were replicated in the METABRIC validation cohort. Without a boost, 78.6% of the patients in the TCGA cohort would have achieved a GARD &gt; 21 (associated with improved tumor control in retrospective series) with the 50 Gy/25 fractions regimen, compared to 64.8% for 40.05 Gy/15 fractions. The addition of an integrated boost significantly increased GARD values: 95.4% of patients receiving 64.4 Gy/28 fractions and 82.5% receiving 48 Gy/15 fractions achieved a GARD &gt; 21. When stratified by molecular subtype, triple-negative breast cancer (TNBC) subtypes showed the greatest benefit from moderate dose escalation, with over 95% of these patients achieving GARD &gt; 21 with a theoretical 53 Gy boost in 15 fractions. EPIC analysis revealed an inverse correlation between RSI and tumor cell content, and positive associations between RSI and specific immune or stromal components, highlighting the importance of tumor purity in interpreting RSI from bulk RNA data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our results support the biological relevance of RSI and GARD in breast cancer to personalize radiotherapy dose escalation in breast cancer patients and demonstrate their consistency across independent datasets and transcriptomic platforms. Tumor microenvironment composition significantly influences RSI estimation from bulk RNA-seq. Tog","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969745","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":"Long-term clinical results of early-stage lung cancer patients treated with risk-adapted stereotactic body radiotherapy using LINAC or CyberKnife : A single-institution analysis of more than 400 cases.","authors":"Zsolt Levente Jánváry, András Bajcsay, Gábor Stelczer, Gábor Kontra, Tamás Pócza, Mercédesz Gerdán, József Lövey, Zsuzsa S Kocsis, Katalin Ladányi, Éva Pap, Tibor Major, Csaba Polgár","doi":"10.1007/s00066-025-02455-3","DOIUrl":"https://doi.org/10.1007/s00066-025-02455-3","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to evaluate the clinical efficacy and side effects of stereotactic body radiotherapy (SBRT) using a gantry-based linear accelerator (LINAC) or robotic technique in a large cohort of consecutively treated medically inoperable early-stage lung cancer patients.</p><p><strong>Methods: </strong>Between March 2015 and February 2023, 401 early-stage (T1-2 N0 M0) primary lung cancer patients were treated using either LINACs (Varian VitalBeam® and TrueBeam®; Varian, Palo Alto, CA, USA) or CyberKnife® (Accuray, Madison, WI, USA). Median age was 70 years (range 44-90). Diagnosis was based on biopsy for 37.4% of patients, while pathological confirmation was unavailable due to high risk for 62.6%. ¹⁸F‑fluorodeoxyglucose positron-emission tomography (18-FDG-PET) was part of the pretreatment diagnostic workup in 96% (n = 386) of the total cohort. Tumor stage distribution was T1a in 32 (8%), T1b in 179 (44.6%), T1c in 112 (27.9%), T2a in 67 (16.7%), and T2b in 11 (2.7%) patients. Applied dose schemes were identical for both LINAC and CyberKnife treatments, using risk-adapted doses of 45-60 Gy in 3 to 8 fractions, (biologically effective dose ranging from 86 to 151.2 Gy BED₁₀).</p><p><strong>Results: </strong>At a median follow-up of 32 months (range 2-104), the crude survival rate was 58%. Median overall survival (OS) was 63 months (95% CI: 51.1-74.8) the 2‑, 3‑, and 4‑year OS rates were 79, 68, and 56%, respectively. Actuarial local control (LC) rates were 94% at 2 years, 90% at 3 years, and 87% at 4 years. Median LC was not reached. Median local progression-free survival (LPFS) and progression-free survival (PFS) rates were 49.5 months (95% CI: 42.8-56.3) and 37 months (95% CI: 31.2.-42.8), respectively. Actuarial 2‑, 3‑, and 4‑year LPFS and PFS rates were 75, 60, and 51% and 66, 51, and 42%, respectively. On multivariate analysis, BED₁₀ ≥ 132 Gy predicted improved LPFS, while earlier tumor stage and better ECOG performance status were associated with improved OS. No grade 3 or higher acute side effects were observed. Grade 3 late side effects occurred in 4 patients (1%), including grade 3 late pulmonary fibrosis in 3 cases and potentially treatment-related grade 3 pneumothorax in 1 patient. Rib fracture was observed in 14 cases (3%).</p><p><strong>Conclusion: </strong>Clinical results after SBRT at a national comprehensive cancer center demonstrate high LC and LPFS rates and favorable PFS and OS, comparable to published studies. Application of a BED₁₀ of 132 Gy or higher shows a potential benefit in terms of LPFS and may thus be recommended in the absence of conflict with organ at risk constraints. SBRT with either LINAC or CK is proven to be a well-tolerated but still highly effective treatment for the elderly, medically inoperable early-stage lung cancer population.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969718","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}