Strahlentherapie und Onkologie最新文献

{"title":"Evaluating the impact of cardiac substructure dosimetric parameters on survival in lung cancer patients undergoing postoperative radiotherapy.","authors":"Melek Tugce Yilmaz, Pervin Hurmuz, Ezgi Gurlek, Demet Yildiz, Mustafa Cengiz","doi":"10.1007/s00066-024-02339-y","DOIUrl":"10.1007/s00066-024-02339-y","url":null,"abstract":"<p><strong>Purpose: </strong>The association of cardiac dosimetric parameters with survival in lung cancer patients is well established. However, most research has concentrated on patients undergoing definitive treatment. This study aims to investigate the relationship between cardiac dosimetric parameters and survival in patients receiving postoperative radiotherapy (PORT).</p><p><strong>Methods: </strong>Sixty patients who received PORT between 2011 and 2021 were retrospectively evaluated. The substructures of the heart were delineated on the simulation computed tomography scans of the patients. Univariate and multivariate Cox regression analyses were conducted to investigate the correlation between dosimetric parameters and overall survival. The Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM Corp., Armonk, NY, USA) was utilized for statistical analyses.</p><p><strong>Results: </strong>Right atrium (RA) maximum dose (Dmax) was the only variable that was significantly associated with a shorter OS. Further receiver operating characteristic (ROC) analysis revealed that the optimum cut-off value for RA Dmax was 43.6 Gy, with a sensitivity of 69% and a specificity of 62%. In addition, inclusion of the upper right paratracheal (2R), lower right paratracheal (4R), left pulmonary ligament (9L), and right hilus (10R) lymphatic stations in the treatment field led to an increase in RA Dmax.</p><p><strong>Conclusion: </strong>The results of this retrospective study show that RA Dmax appears to have an impact on overall survival in patients undergoing PORT. Limiting the RA Dmax dose to below 43.6 Gy and avoiding elective nodal irradiation might potentially enhance survival in this patient cohort.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"452-462"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786864","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":"Radiation-induced heart disease in breast cancer patients: a narrative review of epidemiology, risk factors, radiotherapy parameters, and prevention.","authors":"Aline Van der Vorst, Maarten Lambrecht, Lucas Van Aelst, Jelle Verhoeven, Johanna Jacobs, Adinda Baten, Caroline Weltens","doi":"10.1007/s00066-024-02362-z","DOIUrl":"10.1007/s00066-024-02362-z","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is the most prevalent cancer in women worldwide; nevertheless, the prognosis is good, with a 5-year overall survival of 80-90%. Therefore, it becomes crucial to strive for high quality of life after cure by minimizing treatment-related toxicity. One such concern is radiation-induced heart disease, which remains a significant focus of ongoing investigations.</p><p><strong>Purpose: </strong>The aim of this review is to summarize current knowledge on radiation-induced heart disease in breast cancer patients by giving an overview of its epidemiology, risk factors, radiation parameters related to its development, solutions in radiation practice, and prevention. The goal is to raise awareness and maximize prevention of radiation-induced heart disease.</p><p><strong>Methods: </strong>The PubMed database was screened for articles published between January 2013 and November 2023 related to the keywords <breast cancer>, <radiotherapy>, <cardiac toxicity>, and <heart-sparing techniques>. Moreover, by screening the literature lists of these publications, additional articles were added.</p><p><strong>Results: </strong>Ninety-four relevant papers remained for final review.</p><p><strong>Conclusion: </strong>Radiation-induced heart disease is a rare complication after breast cancer radiotherapy and represents a clinical spectrum of various cardiovascular conditions. Several heart-sparing techniques have been developed, and more attention has been paid to early diagnosis and prevention of radiation-induced heart disease. However, further research remains important to refine radiotherapy techniques and deepen our understanding for improved prevention and treatment of this condition in the future. This clinical review summarizes the existing evidence and literature on radiation-induced heart disease following modern breast cancer radiotherapy, offering clinical guidance for physicians.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"368-382"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459648","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":"Association of long-term treatment outcomes with changes in PET/MRI characteristics and the type of early treatment response during concurrent radiochemotherapy in patients with locally advanced cervical cancer.","authors":"Radovan Vojtíšek, Jan Baxa, Petr Hošek, Petra Kovářová, Martin Vítovec, Emília Sukovská, Jan Kosťun, Pavel Vlasák, Jiří Presl, Jiří Ferda, Jindřich Fínek","doi":"10.1007/s00066-025-02389-w","DOIUrl":"https://doi.org/10.1007/s00066-025-02389-w","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to find predictive tumour characteristics as detected by interim positron-emission tomography/magnetic resonance imaging (PET/MRI) in cervical cancer patients. We also investigated the type of interim response. Furthermore, we compared the investigated parameters with disease-free (DFS) and overall survival (OS) outcomes.</p><p><strong>Methods: </strong>We evaluated 108 patients treated between August 2015 and January 2023 with external-beam radiotherapy (EBRT) and image-guided adaptive brachytherapy (IGABT) who had undergone pretreatment staging, subsequent mid-treatment evaluation after completed EBRT and definitive restaging 3 months after completing the whole treatment using PET/MRI. Patients were then divided into two groups based on the RECIST and PERCIST criteria: responders (achieving complete metabolic response, CMR) and non-responders (non-CMR). These two groups were compared using selected parameters obtained at pre-PET/MRI and mid-PET/MRI. The early response to treatment as evaluated by mid-PET/MRI was categorized into three types: interim complete metabolic response, interim nodal response and interim nodal persistence.</p><p><strong>Results: </strong>Mid-TLG‑S (the sum of total lesion glycolysis for the primary tumour plus pelvic and para-aortic lymph nodes) parameter showed the best discriminatory ability for predicting non-CMR. The second factor with significant discriminatory ability was mid-MTV‑S (the sum of the metabolic tumour volume of the primary tumour plus pelvic and para-aortic lymph nodes). The strongest factor, mid-TLG‑S, showed a sensitivity of 40% and a specificity of 90% at a threshold value of 70. We found a statistically significant association of DFS and OS with the following parameters: number of chemotherapy cycles, early response type and CMR vs. non-CMR.</p><p><strong>Conclusion: </strong>We were able to identify thresholds for selected parameters that can be used to identify patients who are more likely to have worse DFS and OS. The type of early response during concurrent chemoradiotherapy (CCRT) was also significantly associated with DFS and OS. These aspects represent an important contribution to the possible stratification of patients for subsequent individualised adjuvant treatment.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754550","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":"Re-irradiation in progressive diffuse infiltrative pontine glioma in children and young adults.","authors":"Alper Kahvecioglu, Mustafa Cengiz, Guzide Burca Aydin, Mustafa Tezer Kutluk, Gokcen Coban Cifci, Gozde Yazici","doi":"10.1007/s00066-025-02394-z","DOIUrl":"https://doi.org/10.1007/s00066-025-02394-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to assess oncological outcomes in children and young adults with diffuse infiltrative pontine glioma (DIPG) who have progressed after initial radiotherapy (RT), with an emphasis on the role of re-irradiation.</p><p><strong>Methods: </strong>Data from 33 patients aged 25 years or younger with progressive disease after initial RT were retrospectively analyzed.</p><p><strong>Results: </strong>The median age at diagnosis was 8 years (range 4-24 years), and the median initial RT dose was 54 Gy (range 39-54 Gy). The median time between initial RT and progression was 8 months (range 3-40 months). In addition to systemic therapy, 15 patients (46%) received re-irradiation due to progression, with a median dose of 23.4 Gy (range 19.8-36 Gy), while 18 patients (54%) were treated with systemic therapy alone. In patients who received re-irradiation after progression, the 1‑year post-progression overall survival (OS) was significantly higher compared to those treated with systemic therapy alone (27% vs. 0%, p = 0.01). Among the 15 re-irradiated patients, 9 out of 12 with available data (75%) showed improvement in neurological symptoms following re-irradiation. No patient exhibited acute or late RT-related ≥ grade 3 toxicity.</p><p><strong>Conclusion: </strong>Palliative re-irradiation in children and young adults with progressive DIPG after initial RT provides an approximately 3‑month OS benefit and clinical improvement without significant toxicity and should be considered as a standard-of-care approach.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711365","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":"Biomarkers in prostate cancer: current status and future directions in radiotherapy-statement from the Prostate Cancer Working Group of the German Society of Radiation Oncology (DEGRO).","authors":"S K B Spohn, D M Aebersold, C Albrecht, D Boehmer, U Ganswindt, N-S Schmidt-Hegemann, S Hoecht, T Hölscher, S A Koerber, A-C Mueller, P Niehoff, J C Peeken, M Pinkawa, B Polat, M Shelan, F Wolf, C Zamboglou, D Zips, T Wiegel","doi":"10.1007/s00066-025-02388-x","DOIUrl":"https://doi.org/10.1007/s00066-025-02388-x","url":null,"abstract":"<p><strong>Purpose: </strong>Prostate cancer (PCa) is the most frequently diagnosed malignancy among men in Germany. Advances in diagnostics and treatment have transformed PCa into a chronic disease. Given the heterogeneity of PCa, there is a need for additional stratification tools. This review focuses on updating the evidence for genomic classifiers (GC; Decipher [Veracyte Inc. San Diego, CA, USA], Prolaris [Myriad Genetics, Inc., Salt Lake City, UT], and Oncotype DX [Exact Sciences, Madison, WI, USA] tests) and artificial intelligence (AI)-based digital histopathology biomarkers (ArteraAI Prostate Test) in the context of radiotherapy (RT) for PCa.</p><p><strong>Methods: </strong>The members of the Prostate Cancer Working Group of the German Society of Radiation Oncology (DEGRO) conducted an updated literature search on GCs and histopathological biomarkers in PCa, covering original articles published between January 2022 and February 2024 in the PubMed database.</p><p><strong>Results: </strong>In addition to previous reviews, 11 relevant studies were identified, of which nine studies analyzed biomarkers within prospective phase II or III trials. Eight trials focused on genomic biomarkers, of which three addressed GCs in primary localized PCa, three in recurrent PCa in the setting of salvage RT, and two in metastatic castration-sensitive PCa. In localized PCa, GCs could be validated in a retrospective analysis of randomized controlled trials. Additionally, three studies reported on AI-based histopathology biomarkers.</p><p><strong>Conclusion: </strong>Genomic classifiers and AI-based digital histopathology models might have superior prognostic and predictive value compared to established clinical and pathological parameters in localized, recurrent, and metastatic PCa. Despite promising results, prospective validation of these biomarkers in randomized trials remains limited. This review underscores the need for further prospective trials to confirm the usefulness of these biomarkers in PCa.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711330","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":"Stereotactic radiotherapy for spinal and non-spinal bone metastases: a patterns-of-care analysis in German-speaking countries as part of a project of the interdisciplinary Radiosurgery and Stereotactic Radiotherapy Working Group of the DEGRO/DGMP.","authors":"F Nägler, N Gleim, I Seiler, A Rühle, K Hering, C Seidel, E Gkika, D Krug, O Blanck, C Moustakis, T B Brunner, A Wittig-Sauerwein, N H Nicolay","doi":"10.1007/s00066-025-02387-y","DOIUrl":"https://doi.org/10.1007/s00066-025-02387-y","url":null,"abstract":"<p><strong>Background and purpose: </strong>Bone metastases constitute a common indication for both conventional radiotherapy (RT) and stereotactic body radiotherapy (SBRT). Although in recent years guidelines have been proposed for SBRT of spinal and non-spinal metastases, little is known about the use of bone SBRT and the actual patterns of care in German-speaking countries.</p><p><strong>Material and methods: </strong>We performed an online survey among radiation oncologists (ROs) registered with the interdisciplinary Radiosurgery and Stereotactic Radiotherapy Working Group of the German Society of Radiation Oncology (DEGRO) and the German Society for Medical Physics (DGMP) to collect valuable and robust cross-sectional data on patterns of care for bone SBRT in German-speaking countries.</p><p><strong>Results: </strong>Of the registered ROs, 35.5% (75/211) completed the online survey. ROs working in high-volume centers irradiating more than 100 patients with bone metastases annually represented the largest group, with 58.7%. Ablative SBRT was mostly performed for bone oligometastases (78.7%). For symptom-directed palliative radiotherapy, the majority of responding physicians (84.3%) still mostly recommend moderately hypofractionated treatment. Nevertheless, 60.9% of participating ROs stated using bone SBRT at least occasionally, also for palliative purposes such as pain control. Our survey also revealed a certain reluctance for the concomitant use of systemic therapies with bone SBRT and heterogeneity regarding target volume definition and dosing for bone SBRT.</p><p><strong>Conclusion: </strong>Our survey demonstrates that bone SBRT for spinal and non-spinal metastases for oligometastatic disease (OMD) is broadly available in clinical routine care in German-speaking countries. A large heterogeneity regarding indications, dose, and fractionation concepts remains, requiring further efforts for standardization of bone SBRT.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658639","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":"Comparison of integral doses to normal tissue and organs at risk between interstitial high-dose-rate brachytherapy and modern external-beam radiotherapy techniques in breast and head and neck cancer patients.","authors":"Tibor Major, Csaba Polgár, Zoltán Takácsi-Nagy","doi":"10.1007/s00066-025-02382-3","DOIUrl":"https://doi.org/10.1007/s00066-025-02382-3","url":null,"abstract":"<p><strong>Background: </strong>Although a cornerstone of modern cancer treatment, radiotherapy (RT) is associated with a risk of secondary cancer due to irradiation of non-target tissues. Techniques such as intensity-modulated RT (IMRT), volumetric modulated RT (VMAT), and stereotactic body RT (SBRT) provide highly conformal target dose distributions and reduce doses to nearby organs at risk (OARs), albeit at the cost of larger normal tissue volumes being irradiated with lower doses. In brachytherapy (BT), the low-value isodoses cannot be changed: they are a consequence of the inverse-square law. This study evaluates and compares the normal tissue integral doses (NTIDs) delivered by BT and modern external-beam RT (EBRT) techniques in breast and head and neck (H&N) cancer patients.</p><p><strong>Methods: </strong>Included were the BT and IMRT plans of 34 women with early-stage breast cancer treated with interstitial high-dose-rate (HDR) BT and two groups of head and neck (H&N) patients: 38 patients with mobile tongue, floor of the mouth, and base of the tongue cancer treated definitively with interstitial HDR BT for whom VMAT treatment plans were also prepared and 20 patients with tongue and floor of the mouth tumors who received postoperative interstitial HDR BT for whom VMAT and stereotactic CyberKnife (CK, Accuray Inc., Sunnyvale, CA, USA) plans were also created. The NTIDs for three normal tissue volumes (NT_V10, NT_V5, NT_V2) and OARs were calculated and compared.</p><p><strong>Results: </strong>Brachytherapy resulted in 39%, 32%, and 26% lower NTIDs compared to IMRT for NT_V10, NT_V5, and NT_V2, respectively, in patients with breast cancer. In H&N cancer, the NTIDs were always lower for BT compared to VMAT. The reductions in NTID achieved with BT were 45%, 36% and 27% with the same planning target volumes in BT and VMAT, and 56%, 48% and 37% with larger planning target volumes in VMAT. For CK, the NTID reductions were 54%, 49% and 41% compared to BT. In breast cases, BT resulted in a significant reduction in ipsilateral lung NTID, and in H&N cases, salivary glands NTIDs were always lower with BT than with VMAT.</p><p><strong>Conclusion: </strong>For patients with breast and head and neck cancer, interstitial BT results in lower integral dose to normal tissue and OARs compared to modern EBRT techniques. The clinical implications require further detailed investigation.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650895","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":"Correction to: Prostate motion in magnetic resonance imaging-guided radiotherapy and its impact on margins.","authors":"Johannes Kusters, René Monshouwer, Peter Koopmans, Markus Wendling, Ellen Brunenberg, Linda Kerkmeijer, Erik van der Bijl","doi":"10.1007/s00066-025-02390-3","DOIUrl":"https://doi.org/10.1007/s00066-025-02390-3","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624634","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":"Exploring the molecular mechanism of cancer radiosensitization: the impact of physical stimulation therapy.","authors":"Shun Liu, Mingjie Li, Zhili Guo, Zhiyi Chen","doi":"10.1007/s00066-025-02385-0","DOIUrl":"https://doi.org/10.1007/s00066-025-02385-0","url":null,"abstract":"<p><p>Radiotherapy for cancer is a local treatment method that uses radiation to treat tumors. It is one of the main approaches for treating malignant tumors. Radiotherapy uses ionizing radiation on living organisms to cause necrosis of tumor cells. However, the DNA damage repair mechanisms of tumor cells and the hypoxic microenvironment of tumors limit the effectiveness of radiotherapy. Tumor cells can also achieve radioresistance through a variety of signaling pathways. The radiation tolerance of adjacent tissues also directly affects the effect of radiotherapy. Stimulation of tumor cells through physical methods such as ultrasound, light, heat, electricity, and magnetic fields can not only improve the hypoxic microenvironment of tumors and directly damage DNA but can also solve the problem of radioresistance by regulating a variety of signaling molecules. Physical stimulation therapy has high specificity and targeted effects, making it widely used in radiosensitization applications. However, the molecular mechanisms underlying the radiosensitizing effects of physical stimulation therapy are not fully understood at a practical level. In this review, we summarize the signaling pathways related to radioresistance as well as the established and potential molecular mechanisms responsible for radiosensitization induced by physical stimulation to provide insights for future radiosensitivity studies on physical stimulation therapies.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605629","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":"https://doi.org/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":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}