Strahlentherapie und Onkologie最新文献

{"title":"Real world comparison of adjuvant vs. salvage radiation therapy on cancer-control outcomes after radical prostatectomy.","authors":"Mike Wenzel, Katrin Burdenski, Nikolaos Tselis, Claus Rödel, Christian Brandts, Marit Ahrens, Jens Koellermann, Markus Graefen, Clara Humke, Carolin Siech, Benedikt Hoeh, Severine Banek, Felix K H Chun, Philipp Mandel","doi":"10.1007/s00066-025-02400-4","DOIUrl":"https://doi.org/10.1007/s00066-025-02400-4","url":null,"abstract":"<p><strong>Purpose: </strong>Outcomes of adjuvant (aRT) or salvage radiation therapy (sRT) after radical prostatectomy are under investigation regarding cancer-control outcomes.</p><p><strong>Methods: </strong>Relying on the University Cancer Center database elaborating differences in metastasis-free (MFS), cancer-specific (CSS) and overall survival (OS) of aRT vs. sRT-treated patients between 2014-2024. Sensitivity analyses addressed high-risk patients with pN1 and/or Gleason score 8-10 and/or pT3-4 stage.</p><p><strong>Results: </strong>Of 1862 patients, 7.1% underwent aRT and 93% were in the sRT group. Median PSA at sRT was 0.33 ng/ml. Patients with aRT harbored significantly worse baseline tumor and pathological characteristics such as PSA level (12.0 vs. 7.6 ng/ml), Gleason score 9-10 (30% vs. 9.8%), D'Amico high risk prostate cancer (97% vs. 56%), as well as pT3-4, pN1 and positive surgical margins rates (all p < 0.001). Similar observations were made for high-risk patients. No differences were observed for aRT vs. sRT with 60-month MFS rates of 85.1% vs. 95.4% (hazard ratio [HR] 0.60, p = 0.18). 60-months CSS-rates of 96.8% vs. 99.1% and 60-month OS-rates of 91.0% vs. 89.1% respectively (all p ≥ 0.15). Neither sensitivity analyses of high-risk patients nor multivariable adjusted Cox regression models revealed significant differences regarding MFS, CSS or OS in aRT vs. SRT comparison (all p ≥ 0.05), despite aRT showing qualitatively better OS results.</p><p><strong>Conclusion: </strong>Within real-world setting, patients undergoing aRT harbor wore tumor characteristics. However, these differences did not translate into significant differences of mid-term oncological outcomes, relative to sRT patients. Similar observations were made within analyses of high-risk patients with pT3-4 and/or Gleason 8-10 and/or pN1 stage, nevertheless aRT showed slightly higher OS rates within this subgroup.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046601","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":"Survival determinants and toxicity of second-course radiotherapy for isolated nodal recurrences in breast cancer.","authors":"Cezara Cheptea, Youlia Kirova, Jeremy Baude, Fatima Laki, Alain Fourquet, Pierre Loap","doi":"10.1007/s00066-025-02409-9","DOIUrl":"https://doi.org/10.1007/s00066-025-02409-9","url":null,"abstract":"<p><strong>Background: </strong>Isolated nodal recurrence (INR) after localized breast cancer is rare, with an incidence of less than 1%. Curative management typically includes surgical resection, often with axillary lymph node dissection (ALND), followed by regional nodal radiotherapy. However, evidence-based guidelines remain limited due to the rarity of this clinical scenario. The aim of this study was to evaluate survival determinants and the acute and long-term toxicities associated with second-course regional nodal irradiation as part of curative strategies for INR after localized breast cancer.</p><p><strong>Materials and methods: </strong>This retrospective study included 11 patients with localized breast cancer who developed ipsilateral, nonmetastatic INR between 2003 and 2019. All patients were treated with curative intent, including regional nodal irradiation. Overall survival (OS), cancer-specific survival (CSS), metastasis-free survival (MFS), local control, and treatment toxicities were analyzed. Survival probabilities were calculated using the Kaplan-Meier method, and Cox regression was used to assess prognostic factors.</p><p><strong>Results: </strong>The 5‑year OS and CSS were 71.6%, while MFS was 62.3%. Inclusion of internal mammary chain (IMC) irradiation significantly improved OS, CSS, and MFS (p < 0.01). Triple-negative breast cancer (TNBC) INRs were associated with worse survival outcomes. Acute grade 2 toxicities included radiodermatitis (36.4%), and late grade 2 toxicities were limited to fibrosis (18.2%). No cardiac, pulmonary, or grade 3 or higher toxicities were reported.</p><p><strong>Conclusion: </strong>This study highlights the favorable survival outcomes and safety profile of contemporary curative strategies for INRs following localized breast cancer, with a 5-year OS rate exceeding historical benchmarks. Internal mammary chain irradiation appears to improve survival without increased toxicity. However, the poor prognosis associated with TNBC INR underscores the need for effective systemic therapies. Prospective multicenter trials are essential to validate these findings and optimize treatment protocols.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032432","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: Precision matters: the value of PET/CT and PET/MRI in the clinical management of cervical cancer.","authors":"Yulin Zou, Sijin Zhu, Yinwu Kong, Chengtao Feng, Ru Wang, Linping Lei, Yaomin Zhao, Long Chen, Li Chang","doi":"10.1007/s00066-024-02330-7","DOIUrl":"10.1007/s00066-024-02330-7","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"519"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732872","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":"Neoadjuvant radiochemotherapy in patients with high-risk locally advanced cervical cancer-results of a clinical series.","authors":"S Donath, M A Schirmer, F Bremmer, A Seif, L H Dröge, M Guhlich, L A Fischer, D A Ziegler, S Ziegler, M Leu, C F Pagel, C M Zwerenz, J T Oelmann, R El Shafie, A Hille, H E Ammon, G Fleckenstein, C F Hess, S Rieken, S Bendrich","doi":"10.1007/s00066-024-02340-5","DOIUrl":"10.1007/s00066-024-02340-5","url":null,"abstract":"<p><strong>Purpose: </strong>Neoadjuvant radiochemotherapy (NARCT) is an established standard of care in various tumor entities, promoting high response rates at commonly lower toxicities as compared to adjuvant approaches. This retrospective analysis was designed to investigate NARCT in early-stage high-risk cervical cancer.</p><p><strong>Methods: </strong>Forty patients with early-stage high-risk cervical cancer (i.e., L1, V1, G3, N+, > ²/₃ stromal invasion, > 4 cm tumor size, borderline resectability) were treated with NARCT prior to surgical resection. Downstagings based on clinical, imaging, and pathological responses were recorded. Survival rates were calculated according to Kaplan-Meier, and prognostic factors were analyzed with uni- and multivariable Cox regression analyses using SPSS software (v. 26; IBM Corp., Armonk, NY, USA).</p><p><strong>Results: </strong>Both NARCT and subsequent tumor resection were feasible and conducted in 39 of 40 patients (95%). Early toxicity was moderate, with no grade 3 or higher toxicities following NARCT and surgery. NARCT yielded significant downstaging in all patients, and pathological complete remission (pCR) was achieved in 14 patients (36%). After 5 years, overall survival (OS), freedom from local progression (FFLP), and freedom from distant progression (FFDP) rates were 84.2%, 75.9%, and 73.1%, respectively. Late proctitis (grade 1 in 8%) and urinary cystitis (grade 1-3 in 35%) occurred at acceptable rates.</p><p><strong>Conclusion: </strong>In resectable early-stage high-risk cervical cancer, NARCT is feasible and safe. Clinical, imaging, and pathological response rates are high. Impressive long-term survival and tumor control rates at modest toxicities encourage the initiation of a prospective and randomized trial.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"537-545"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955460","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":"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":"546-560"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014719/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy for painful shoulder syndrome: a retrospective evaluation.","authors":"Ronny Leist, Oliver Micke, M Heinrich Seegenschmiedt, Irenaeus A Adamietz, Kashyar Fakhrian, Ralph Muecke","doi":"10.1007/s00066-024-02302-x","DOIUrl":"10.1007/s00066-024-02302-x","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated the efficacy of low-dose radiotherapy for painful shoulder syndrome from an orthopedic perspective.</p><p><strong>Methods: </strong>Patients with painful shoulder syndrome were recruited for this retrospective clinical quality assessment from January 2011 to December 2017. Patients were treated with a linear accelerator or an orthovoltage device at individual doses of 0.5-1.0 Gy and total doses of 3.0-6.0 Gy. To assess response, we used the von Pannewitz score with five levels: \"worsened,\" \"unaffected,\" \"improved,\" \"significantly improved,\" and \"symptom free.\" \"Good treatment success\" was defined as \"significantly improved\" and \"symptom free.\" Within-group and between-group differences were statistically evaluated.</p><p><strong>Results: </strong>Of 236 recruited patients (150 women, 86 men; mean age 66.3 [range 31-96] years), 180 patients underwent radiotherapy with a linear accelerator and 56 with an orthovoltage device. Fractionation was 12 × 0.5 Gy in 120 patients, 6 × 0.5 Gy in 74, and 6 × 1 Gy in 42 patients. Treatments were completed in one series for 223 and in two series at least 6 weeks apart for 13 patients. Of the 236 patients, 163 patients (69.1%) agreed to be re-interviewed at a median of 10.5 (range 4-60) months after radiotherapy completion. Directly after radiotherapy, 30.9% (73 patients) had \"good treatment success,\" which had increased to 55.2% (90 patients) at follow-up.</p><p><strong>Conclusion: </strong>Protracted pain improvement with low-dose radiotherapy is possible in painful shoulder syndrome. Patients with refractory pain because of subacromial syndrome or shoulder osteoarthritis should also be evaluated for radiotherapy.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"495-500"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308585","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":"Comparative effectiveness of kilo- and megavoltage energies in low-dose radiotherapy for painful degenerative musculoskeletal diseases: a systematic review and meta-analysis.","authors":"Aram Kim, Jeanny Kwon, Ji Young Kim, Byoung Hyuck Kim","doi":"10.1007/s00066-024-02329-0","DOIUrl":"10.1007/s00066-024-02329-0","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the impact of different energy levels on the effectiveness of low-dose radiotherapy (LDRT) for treating painful degenerative musculoskeletal diseases, as comparative efficacy data are currently lacking.</p><p><strong>Methods: </strong>A systematic review was conducted in PubMed, Embase, and the Cochrane Library databases to identify studies with response information on the energy used (kilovoltage [kV] vs. megavoltage [MV]). The primary endpoint was the overall response rate (ORR), and the secondary endpoint was the complete response rate (CRR). Exploratory subgroup analyses included treatment site, study period, study design, country, and dose per fraction.</p><p><strong>Results: </strong>A total of 33 studies involving 12,143 patients were analyzed. Short-term follow-up (up to 6 months) showed a pooled ORR of 64% (95% CI 46-78%) for kV and of 62% (95% CI 54-70%) for MV. Long-term follow-up (at least 12 months) revealed a pooled ORR of 85% (95% CI 65-95%) for kV and of 69% (95% CI 62-75%) for MV. Subgroup analysis indicated no significant differences in ORR for energy level stratified by treatment site and other factors. Regarding dose per fraction (0.5 Gy vs. 1.0 Gy), comparable ORRs were demonstrated between the two energies. No clinical side effects were noted.</p><p><strong>Conclusion: </strong>This meta-analysis suggests that the known effectiveness of LDRT in painful degenerative musculoskeletal disease may not depend on the energy used. Additional studies using standardized evaluation methods are warranted to establish consistency and enhance the comprehensiveness of research. Further research is also needed to explore treatment modality selection considering disease-specific biology.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"483-494"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781109","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":"[Stereotactic ablative radiotherapy (SABR) without chemotherapy in oligometastasized head and neck carcinoma (GORTEC 2014-04 \"OMET\")].","authors":"Jörg Andreas Müller, Dirk Vordermark","doi":"10.1007/s00066-025-02384-1","DOIUrl":"10.1007/s00066-025-02384-1","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"570-572"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524481","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 quality of life between single-modality adjuvant endocrine therapy versus radiotherapy for patients with low-risk breast cancer].","authors":"Sophia Drabke, David Krug","doi":"10.1007/s00066-025-02383-2","DOIUrl":"10.1007/s00066-025-02383-2","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"567-569"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493440","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 effect of incidental dose to pelvic nodes in bladder-only irradiation in the era of IMRT: a dosimetric study.","authors":"Gokhan Ozyigit, Alper Kahvecioglu, Mustafa Cengiz, Fazli Yagiz Yedekci, Pervin Hurmuz","doi":"10.1007/s00066-024-02246-2","DOIUrl":"10.1007/s00066-024-02246-2","url":null,"abstract":"<p><strong>Purpose: </strong>While three-dimensional radiotherapy (RT) causes high incidental nodal doses in bladder-only irradiation for muscle-invasive bladder cancer (MIBC), the impact on pelvic lymphatics is unclear in the era of intensity-modulated RT (IMRT). This study evaluates incidental doses to pelvic lymphatics in MIBC patients treated with IMRT.</p><p><strong>Methods: </strong>The data of 40 MIBC patients treated with bladder-only IMRT and concurrent chemotherapy were retrospectively evaluated. The pelvic lymphatics were contoured on initial simulation images and incidental nodal doses were evaluated. The Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM, Armonk, NY, USA) was used for statistics.</p><p><strong>Results: </strong>Median RT dose to the bladder was 60 Gy in 30 fractions. In dosimetric analysis, median values of mean dose (D_mean) of the obturator, presacral, external iliac, internal iliac, and distal common iliac lymphatics were 33 Gy (range 4-50 Gy), 3 Gy (range 1-28 Gy), 9.5 Gy (range 3-41 Gy), 7.5 Gy (range 2-14 Gy), and 1 Gy (range 0-15 Gy), respectively. The D_mean of the obturator lymphatics was significantly higher (p < 0.001) and the D_mean of the distal common iliac lymphatics was significantly lower (p < 0.001) than all remaining lymphatic stations. The D_mean of the external iliac lymphatics was significantly higher than that of the presacral lymphatics (p < 0.001), but the difference with the internal iliac lymphatics was not statistically significant (p = 0.563).</p><p><strong>Conclusion: </strong>The incidental nodal doses with bladder-only IMRT are heterogeneous and remain below the generally accepted doses for microscopic disease eradication for bladder cancer.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"501-506"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421057","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}