Strahlentherapie und Onkologie最新文献

{"title":"[Long-term results of the euro-Ewing99-study].","authors":"Christian Schulz, Jürgen Dunst","doi":"10.1007/s00066-026-02604-2","DOIUrl":"https://doi.org/10.1007/s00066-026-02604-2","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081575","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":"Development of a prospective clinical workflow for proton beam therapy of ventricular tachycardia.","authors":"Ariadna Cherit Hernández, Martina C Fuss, Melanie Grehn, Valeria Trojani, Claus Schmitzer, Günter Gruber-Hammer, Jingyang Xie, Dietmar Georg, Lukas Fiedler, Piero Fossati, Oliver Blanck, Markus Stock","doi":"10.1007/s00066-026-02599-w","DOIUrl":"https://doi.org/10.1007/s00066-026-02599-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study presents a prospective preclinical workflow for proton beam therapy of refractory ventricular tachycardia (VT), covering target transfer, treatment planning (TP), and beam gating.</p><p><strong>Methods: </strong>Photon-based stereotactic arrhythmia radioablation (STAR) protocols were adapted to proton beam therapy, encompassing (i) target transfer from electroanatomical mapping (EAM) onto planning computed tomography (CT), (ii) simulation of three TP cases from the Standardized Treatment and Outcome Platform for Stereotactic Therapy of Re-Entrant Tachycardia by a Multidisciplinary (STOPSTORM.eu) benchmark, and (iii) evaluation of trigger events and delays for synchrotron beam delivery control using gating.</p><p><strong>Results: </strong>CARDIO-RT enabled electroanatomical mapping to computed tomography (EAM-to-CT) target transfer; two experienced cardiologists qualitatively judged the transferred targets as clinically acceptable by visual inspection. Treatment plans demonstrated effective organ at risk (OAR) sparing and clinical adequacy. The planning target volume (PTV) D_95% ranged from 23.3 to 23.9 Gy relative biological effectiveness (RBE) and the clinical target volume electrophysiology (CTV [EP]) D_95% from 30.9 to 31.6 Gy (RBE); underdosage was permitted where anatomical compromise was unavoidable. No CTV(EP) hotspot exceeded 33.5 Gy (RBE). Optical trigger signals are supported for beam gating; the total cardiac gating chain latency was below 30 ms.</p><p><strong>Conclusion: </strong>This technical feasibility study demonstrates a prospective preclinical workflow for proton beam STAR, covering EAM-to-CT target transfer, TP across three benchmark clinical cases, and accelerator-side optical gating integration at a synchrotron-based facility. The workflow demonstrates technical feasibility; however, full clinical translation still requires patient positioning and verification, motion characterization, and end-to-end validation. Future work will employ a dynamic anthropomorphic phantom to characterize motion-induced dosimetric changes and assess plan robustness for proton and carbon ion beam delivery.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075929","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":"First dosimetric evaluation of deformable dose accumulation in human individuals.","authors":"Yvonne Dzierma, Sina Etemad Zadeh, Thomas Tschernig, Jan Palm, Angelika Loose-Altergot, Svenja Ganz, Markus Hecht, Frank Nuesken, Christina Kraemer, Hendrik Auerbach","doi":"10.1007/s00066-026-02595-0","DOIUrl":"https://doi.org/10.1007/s00066-026-02595-0","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to dosimetrically validate deformable dose accumulation in online adaptive radiotherapy using realistic physiological tissue deformation and comparing point dose measurements to the treatment planning system-calculated and accumulated point dose.</p><p><strong>Methods: </strong>For the data analysis, four real human body donors were used after fixation to preserve physiological tissue elasticity. Online adaptive radiotherapy was performed using the Varian Ethos system for variable bladder and bowel filling as created using catheters. The dose to the bladder, urethra, and rectum was measured using thermoluminescent dosimeters. The measured dose at each point was compared with the sum of the single-fraction adaptive doses and with the accumulated dose.</p><p><strong>Results: </strong>On average, the summation of point doses from the individual fractions (adapted plan as calculated by the Ethos software) is consistent with the accumulated dose, demonstrating internal consistency of the Ethos system regarding deformable dose summation. However, from the 46 point doses analyzed, 22 show deviations larger than ± 10% and 16 more than ± 20%. Comparing the measurements with the treatment planning system summation dose, the Ethos appears to somewhat underestimate the dose.</p><p><strong>Conclusion: </strong>To our knowledge, these measurements are the first presentation of point dose measurements in soft-fixed human bodies under physiological organ deformation. The experimental set-up is challenging, but feasible, providing an end-to-end validation of deformable dose accumulation. While there is general consistency within the Ethos system between the single-fraction adaptive dose distributions and the resulting accumulated dose distribution, specific locations appear to be matched incorrectly and can result in considerable internal inconsistencies.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064379","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":"Centralization of MR image-guided adaptive brachytherapy for cervical cancer in Austria: feasibility and outcomes.","authors":"J Knoth, H Ramadan, E M Weis, G Kurzweil, B Celedin, O Komina, J Salinger, J Böswarth, S Skorbier, M Buchegger, S Kartal, S Flatz, J Frey, O Gomez, M Kopp, M Metz, A de Vries, T Brunner, J Widder, A Reim, N Eder-Nesvacil, C Kirisits, W Raunik, P Georg, H Geinitz, A Sturdza, M P Schmid","doi":"10.1007/s00066-026-02607-z","DOIUrl":"https://doi.org/10.1007/s00066-026-02607-z","url":null,"abstract":"<p><strong>Purpose: </strong>Magnetic resonance image-guided adaptive brachytherapy (MR-IGABT) is the standard of care for definitive radiochemotherapy in locally advanced cervical cancer, but radiotherapy departments with sufficient case volume and unrestricted access to MRI capacity remain limited. This study evaluated the feasibility and outcomes of a nationwide Austrian model combining decentralized external-beam radiotherapy (EBRT) with centralized MR-IGABT.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included patients with FIGO IB-IVA cervical cancer treated between 2018 and 2022 who received EBRT ± concomitant chemotherapy at external Austrian institutions and were subsequently referred to the Medical University of Vienna for brachytherapy. All patients received four fractions of MR-IGABT with MRI-based target delineation according to GEC-ESTRO recommendations. Primary endpoints were local control (LC) and overall survival (OS). Secondary endpoints included pelvic lymph node control (PLNC), recurrence-free survival (RFS), and grade ≥ 3 morbidity requiring medical intervention.</p><p><strong>Results: </strong>Eighty-nine patients from nine institutions were analyzed. Median age was 52 years; 54% had T2b disease and 60% nodal involvement, including 17% paraaortic nodes. Median overall treatment time was 50 days, with a median 6.5-day interval between EBRT and brachytherapy. Combined intracavitary/interstitial brachytherapy was used in 87%, with a median of six needles. The median CTV_HR D90 was 91 Gy EQD2. After a median follow-up of 36 months, the estimated 3‑year OS was 74%, LC 95%, PLNC 95%, and RFS 65%. Recurrences were predominantly distant. Grade ≥ 3 morbidity occurred in 26.1%.</p><p><strong>Conclusion: </strong>Centralized MR-IGABT within a nationwide referral network is feasible and enables guideline-conform, high-quality cervical cancer treatment in a real-world setting.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064375","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":"Acute toxicity and patient-reported quality of life during daily online adaptive radiotherapy versus conventional IGRT for localized prostate cancer: a prospective parallel cohort study.","authors":"Goda Kalinauskaite, Luise A Künzel, Kerstin Rubarth, Jakob Dannehl, Celina Höhne, Marcus Beck, Arne Grün, Julia Bauer, Thomas Wiegel, Reinhard Thamm, Daniel Zips, Carolin Senger","doi":"10.1007/s00066-026-02596-z","DOIUrl":"https://doi.org/10.1007/s00066-026-02596-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to prospectively compare clinician-reported acute toxicity and patient-reported health-related quality of life (HRQoL) between daily cone-beam CT (CBCT)-based online adaptive radiotherapy (oART) and image-guided radiotherapy (IGRT) in patients with localized prostate cancer treated with moderate hypofractionation.</p><p><strong>Materials and methods: </strong>In this prospective study, 74 patients with localized prostate cancer received either CBCT-based oART (n = 43) or CBCT-based IGRT (n = 31) with 62/57.6/48 Gy in 20 fractions, allocated pragmatically by convenience. Acute gastrointestinal (GI) and genitourinary (GU) toxicity was assessed weekly using CTCAE v5.0, and HRQoL was evaluated using the EORTC QLQ-C30 questionnaire at baseline and the end of therapy. Between-group differences were tested using Boschloo's exact test, Wilcoxon rank-sum test and t-tests; temporal and between-group changes were evaluated based on minimally clinically important differences (MCIDs).</p><p><strong>Results: </strong>Baseline patient and treatment characteristics were similar, except for more high-/very high-risk tumors in the oART group (40.5% vs. 9.7%; p = 0.03). Online ART was associated with more favorable gastrointestinal toxicity, reflected by lower maximum toxicity grades (p = 0.028). Maximum genitourinary toxicity was comparable between groups (p = 0.793). More IGRT patients exceeded MCID thresholds for fatigue (74% vs. 37%; p = 0.004), physical functioning (27% vs. 3%; p = 0.009), and role functioning (48.1% vs. 22.9%; p = 0.04). Differences for global health, pain, social function, and diarrhea were not statistically significant but consistently favored oART.</p><p><strong>Conclusion: </strong>Daily CBCT-based oART and IGRT were both well tolerated, with low rates of high-grade acute toxicity. In this exploratory analysis, oART was associated with a more favorable GI toxicity profile and better preservation of HRQoL. These hypothesis-generating findings suggest that adaptive workflows may provide measurable patient-centered benefits during prostate radiotherapy and warrant confirmation in larger prospective studies.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064452","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 central lung cancer-a monocentric detailed analysis.","authors":"Florian Farnik, Juliane Szkitsak, Johann Brand, Tobias Brandt, Rainer Fietkau, Stefanie Corradini, Philipp Schubert, Marlen Haderlein","doi":"10.1007/s00066-026-02597-y","DOIUrl":"https://doi.org/10.1007/s00066-026-02597-y","url":null,"abstract":"<p><strong>Purpose: </strong>Lung cancer still continues to be associated with a high rate of locoregional recurrence, which remains a therapeutic challenge. Re-irradiation can be a viable treatment option; however, due to the proximity to critical organs, it requires special caution, particularly in cases of centrally located recurrences. The aim of this analysis was to evaluate our monocentric experience of re-irradiation of central lung cancer recurrences with individual dose prescription in terms of treatment outcomes and to conduct a detailed dosimetric analysis.</p><p><strong>Methods: </strong>In this single-centre study, 30 patients who received type 2 re-irradiation between 2014 and 2024 for a centrally located lung cancer recurrence were analyzed. Overall survival (OS), progression-free survival (PFS) and local control (LC) were calculated using the Kaplan-Meier method. Prognostic factors were evaluated using univariate log-rank tests and multivariate Cox regression. The values for the dosimetric analysis were determined by registering the radiation therapy planning CT scans from the first and second courses of radiotherapy.</p><p><strong>Results: </strong>The cohort consisted of n = 24 (80%) patients with non-small cell lung cancer (NSCLC) and n = 6 (20%) small cell lung cancer (SCLC). At the time of locoregional recurrence diagnosis, 40% presented with metastatic disease. The median follow-up time was 10 months (range: 0-69). The median interval between the first and second course of radiation therapy was 12 months (range: 2-97). The median total equivalent dose in 2 Gy fractions (EQD2) of re-irradiation was 49.5 Gy (α/β = 10). The 1‑year OS, 1‑year PFS and 1-year LC rates were 61%, 19.3% and 80.1%, respectively. Disease progression occurred predominantly in the form of distant metastases (n = 13, 59.1%), followed by local (n = 4, 18.2%) and locoregional relapse (n = 3, 13.6%). In the multivariate analysis, only patient age over 65 years was identified as an independent predictor of improved PFS, while no independent prognostic factors were found for overall survival or local control. It is noteworthy that re-irradiation was well tolerated; there was a single case of grade 3 late toxicity in the form of esophageal stenosis and one case of grade 2 radiation induced pneumonitis. All patients whose cumulative V60 dose to the esophagus exceeded 50% developed clinically relevant acute grade 2 esophagitis (n = 5, 16.7%).</p><p><strong>Conclusion: </strong>Overall, our results support the growing evidence that thoracic re-irradiation for centrally located lung cancer can achieve favorable local control with acceptable and manageable toxicity.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040641","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":"Impact of PET/CT imaging on target volume delineation and radiotherapy planning in patients with locally advanced esophageal cancer.","authors":"Vera Ashykhmina, Arpad Dezsö, André Glowka, Tatiana Lushchaeva, Pauline Riethmueller, Stanislav Tchaikovski, Daniel Medenwald","doi":"10.1007/s00066-026-02605-1","DOIUrl":"https://doi.org/10.1007/s00066-026-02605-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and purpose: &lt;/strong&gt;Combined chemoradiotherapy is a key treatment strategy for esophageal cancer in both neoadjuvant and definitive settings. Accurate and consistent target volume delineation is essential to optimize therapeutic efficacy and minimize toxicity. &lt;sup&gt;18&lt;/sup&gt;F-fluorodeoxyglucose (&lt;sup&gt;18&lt;/sup&gt;F-FDG) positron emission tomography/computed tomography (PET/CT) enables visualization of metabolically active tumor regions and may improve the accuracy and reproducibility of target volume definition. This retrospective study aimed to evaluate the impact of PET/CT-guided contouring on target volume size, target volume geometry, organ-at-risk exposure, and interobserver variability compared with conventional CT-based delineation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Twenty patients treated between 2022 and 2024 at the Department of Radiation Oncology, University Hospital Magdeburg, were included. Gross tumor volumes (GTVs) were independently delineated on CT and PET/CT datasets. Clinical target volumes (CTVs) and planning target volumes (PTVs) were subsequently generated. Geometric agreement was assessed using the Dice similarity coefficient (DSC) and 95th percentile Hausdorff distance (HD95). Interobserver variability was evaluated using simultaneous truth and performance level estimation (STAPLE)-generated reference contours. Paired t‑tests (α = 0.05) were used to assess volumetric and dosimetric differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;PET/CT-based planning significantly reduced PTV volumes, with mean PTV decreasing from 602.3 ± 267.4 cm&lt;sup&gt;3&lt;/sup&gt; to 453.2 ± 237.4 cm&lt;sup&gt;3&lt;/sup&gt; (p &lt; 0.001). In four patients (20%), more than 100 cm&lt;sup&gt;3&lt;/sup&gt; of the PET-defined target volume was located outside the original CT-based PTV, indicating clinically relevant geometric modification of irradiation fields. Eight patients (40%) showed HD95 values exceeding 25 mm between CT- and PET/CT-based target volumes. PET/CT-based planning also reduced pulmonary radiation exposure, with lung V20 decreasing from 10.39 ± 1.23% to 7.85 ± 1.18% (p = 0.001) and lung V30 from 4.41 ± 0.76% to 2.46 ± 0.37% (p = 0.003). No significant reduction in cardiac or left anterior descending coronary artery (LAD) exposure was observed. Interobserver analysis demonstrated comparable overall agreement between CT- and PET/CT-based contouring, with lower HD95 variability for PET/CT-based delineation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;PET/CT-guided radiotherapy planning substantially influences target volume geometry in esophageal cancer and enables identification of metabolically active disease not adequately covered by CT-based planning alone. In addition to significant target volume reduction and lower pulmonary dose exposure, PET/CT-based contouring may support more consistent target volume delineation. Prospective studies are warranted to determine whether these geometric and dosimetric advantages translate into improved oncologic outcomes","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040550","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":"Anorectal substructure dosimetry and low anterior resection syndrome after neoadjuvant radiotherapy for rectal cancer: an exploratory analysis.","authors":"Fabrizio Sanna, Daniele Delogu, Maria Chiara Ninniri, Giulia Deiana, Elena Pisanu, Angela Pia Solazzo, Grazia Lazzari, Salvatrice Campoccia","doi":"10.1007/s00066-026-02602-4","DOIUrl":"https://doi.org/10.1007/s00066-026-02602-4","url":null,"abstract":"<p><p>Low anterior resection syndrome (LARS) is a frequent complication after sphincterpreserving surgery for rectal cancer, often exacerbated by neoadjuvant radiotherapy. While radiotherapy is a recognized risk factor, the specific contribution of dose to anorectal substructures remains unclear. This retrospective study evaluated whether dosimetric parameters of key anorectal components are associated with postoperative dysfunction. We analyzed 25 patients treated with long-course neoadjuvant radiotherapy followed by surgery, with available dose-volume histogram data and LARS assessment performed at least 6 months after restoration of bowel continuity. The primary endpoint was dichotomized LARS (no LARS vs any LARS). Dose metrics for the internal anal sphincter (IAS), puborectalis muscle (PRM), external anal sphincter (EAS), levator ani muscle (LAM), and a composite IAS-PRM structure were analyzed. High-dose parameters showed the strongest associations with LARS. Among single structures, IAS V50, IAS maximum dose, PRM V50, and IAS V45 were the most significant predictors. The composite metric (IAS+PRM V50) demonstrated a strongassociation with dysfunction (median 0 vs 77.5; p = 0.000062; ρ = 0.82). Lower-dose and mean-dose metrics were less informative. EAS and LAM parameters showed weaker but still significant correlations. These findings suggest that LARS is more strongly associated with high-dose exposure to structures involved in passive continence and anorectal support, particularly the IAS-PRM complex. This supports a functional-unit approach to anorectal toxicity. Although limited by small sample size and retrospective design, the results identify clinically relevant candidate dosimetric parameters. If validated, reducing high-dose exposure to the IAS-PRM complex may improve functionaloutcomes without compromising oncological treatment.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040605","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":"Thirty-Two Years of Radiotherapy for T1 Anal Cancer: Patterns, Outcomes, and Side-effects at a Single Institution.","authors":"I M Simek, S Piroty-Dehbokry, J Widder, R Schmid, J Knoth","doi":"10.1007/s00066-026-02606-0","DOIUrl":"https://doi.org/10.1007/s00066-026-02606-0","url":null,"abstract":"<p><strong>Purpose: </strong>Definitive chemoradiotherapy is the standard treatment for anal cancer, but the optimal management of small (T1) tumours remains unclear, as these tumours are underrepresented in prospective trials.</p><p><strong>Methods: </strong>We retrospectively analysed all patients with T1 anal carcinoma treated with curative intent at the Medical University of Vienna between 1990 and 2022. Patient, tumour, and treatment characteristics were extracted. Outcomes included overall survival (OS), disease-free survival (DFS), colostomy-free survival (CFS), and acute and late toxicity. Kaplan-Meier estimates, log-rank tests, and univariable Cox regression were used for exploratory time-to-event analyses.</p><p><strong>Results: </strong>Fifty-five patients (median age 67 years, range 31-86; female/male ratio 2.4:1) were included. The median prescribed dose was 58 Gy; 45% received concurrent chemotherapy and 35% a brachytherapy boost. Five-year OS, DFS, and CFS were 84.7%, 80.1%, and 85.3%, respectively. Late grade 3 toxicity occurred in six patients (11%), exclusively after 2D/3D radiotherapy. No statistically significant OS or DFS differences were demonstrated for brachytherapy, chemotherapy, nodal involvement, or IMRT/VMAT in exploratory univariable analyses.</p><p><strong>Conclusions: </strong>Patients with T1 anal carcinoma achieved favourable long-term tumour control and organ preservation after definitive radiotherapy or chemoradiotherapy. Severe late toxicity was observed only after 2D/3D radiotherapy; however, concurrent changes in treatment technique, dose, target volumes, and treatment era preclude attribution of this observation to any single treatment component. Numerically favourable outcomes with brachytherapy and concurrent chemotherapy were observed, but these findings remain hypothesis-generating and require validation in prospective studies.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040621","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":"Upfront radiotherapy as part of the multimodal treatment of intravascular papillary endothelial hyperplasia (Masson's tumor) of the neurocranium-a case report and review of the literature.","authors":"Niklas Benedikt Pepper, David Rene Steike, Dorothee-Cäcilia Spille, Enrico Küllenberg, Walter Stummer, Hans Theodor Eich","doi":"10.1007/s00066-026-02598-x","DOIUrl":"https://doi.org/10.1007/s00066-026-02598-x","url":null,"abstract":"<p><strong>Purpose: </strong>Intravascular papillary endothelial hyperplasia (IPEH, \"Masson's tumor\") is a rare benign tumor of vascular origin. It may occur at various anatomical sites and is often preceded by local stress conditions such as trauma or even stereotactic radiotherapy. The treatment normally requires surgical resection, as tumors are able to grow rapidly and cause symptoms that can limit activities of daily life.</p><p><strong>Methods: </strong>We present the case of a 77-year-old woman developing IPEH in the left supraorbital skull after facial trauma, leading to rapid mutilating tumor growth and causing loss of functionality of the left eye. Since a surgical approach was initially not possible due to the bleeding risk, local radiotherapy was applied. Because radiotherapy can also be a cause of IPEH, we discuss its use as part of a multimodal treatment strategy based on the available literature.</p><p><strong>Results: </strong>Evidence regarding the optimal treatment of IPEH is limited. Several case reports link its appearance to prior stereotactic radiotherapy. In our case, the application of normofractionated radiotherapy resulted in a stop of tumor growth. After additional necrosectomy, the patient regained functionality of her left eye and was less limited in everyday activities.</p><p><strong>Conclusion: </strong>While stereotactic radiotherapy has been linked to the development of IPEH in selected reports, normofractionated radiotherapy achieved meaningful local control in this case and facilitated further surgical treatment.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031132","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}