Strahlentherapie und Onkologie最新文献

{"title":"Long term outcomes of prostate cancer patients aged 55 years or younger treated with definitive radiotherapy: Trod 09-005 study.","authors":"Caglayan Selenge Beduk Esen, Aysenur Elmali, Birhan Demirhan, Ozan Cem Guler, Selvi Tabak Dincer, Ilknur Alsan Cetin, Meral Kurt, Mustafa Akin, Ertugrul Senturk, Serap Akyurek, Halil Cumhur Yildirim, Gulhan Guler Avci, Pelin Altinok, Hamit Basaran, Gokhan Ozyigit, Pervin Hurmuz, Cem Onal","doi":"10.1007/s00066-025-02470-4","DOIUrl":"https://doi.org/10.1007/s00066-025-02470-4","url":null,"abstract":"<p><strong>Purpose: </strong>Evidence on the use of definitive radiotherapy (RT) in younger prostate cancer (PCa) patients is limited, with no national-level studies systematically evaluating oncologic outcomes and treatment-related toxicity in this population. This study aimed to assess oncologic outcomes and toxicity of definitive prostate RT in patients aged 55 years or younger.</p><p><strong>Methods: </strong>Records of 180 PCa patients aged ≤ 55 years treated with definitive RT ± androgen deprivation therapy across 12 cancer centers were retrospectively reviewed. Primary endpoints included freedom from biochemical failure (FFBF) and PCa-specific survival (PCSS). Secondary endpoints were overall survival (OS), acute/late genitourinary (GU) and gastrointestinal (GI) toxicities, local recurrence (LR), and distant metastasis (DM).</p><p><strong>Results: </strong>Median age was 54 years; median PSA at diagnosis was 10.4 ng/mL. Risk group distribution was 29% low-, 29% intermediate-, and 42% high-risk. Median RT dose was 76 Gy delivered in 38 fractions. After a median follow-up of 106.2 months, local recurrence (9%), distant metastasis (7%), and isolated PSA progression (3%) were noted. The 8‑year FFBF, PCSS, and OS were 85.7%, 93.8%, and 90.3%, respectively. Univariate analysis identified PSA, clinical T stage, Gleason score (GS), and risk group as significant prognostic factors for FFBF and PCSS. Multivariate analysis showed advanced stage and high GS independently predicted worse FFBF and PCSS. Acute and late grade ≥ 2 GU toxicity occurred in 12% and 6%, and GI toxicity in 11% and 3%.</p><p><strong>Conclusion: </strong>Definitive radiotherapy is a safe and effective treatment for prostate cancer patients aged ≤ 55 years. Prospective studies are needed to confirm these findings.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125995","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":"Outcomes of craniospinal radiotherapy in adult medulloblastoma: survival, long-term toxicities, and quality of life assessment with SF-12 and t-Cog.","authors":"Ecem Demir, Meltem Dağdelen, Derya Bölükbaş, Ahmet Torun, Ömer Faruk Demirel, Zeliha Kübra Çakan, Ömer Erol Uzel","doi":"10.1007/s00066-025-02469-x","DOIUrl":"https://doi.org/10.1007/s00066-025-02469-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated survival outcomes and chronic side effects in adult medulloblastoma patients treated with craniospinal irradiation (CSI).</p><p><strong>Methods: </strong>We performed a retrospective analysis of 30 adult medulloblastoma patients treated with postoperative craniospinal radiotherapy (RT; 30-36 Gy) combined with a posterior fossa/tumor bed boost (54 Gy). Kaplan-Meier methods were used to analyze local control (LC) and survival. Long-term quality of life was assessed using the 12-Item Short Form Health Survey (SF-12) questionnaire and the telephone cognitive evaluation (T-Cog) test.</p><p><strong>Results: </strong>With a median follow-up of 87 months, 10 patients (33.3%) died, 6 due to craniospinal fluid (CSF) recurrence and 4 from distant metastases. The 5‑year local control (LC) and overall survival (OS) rates were 85% and 71%, respectively. Alopecia (64.7%), cognitive decline (41.1%), and ototoxicity (41.1%) were common long-term toxicities, with 5 of 7 ototoxicity cases linked to cisplatin. Secondary tumors occurred in 2 patients. Cognitive impairment was indicated by a mean T‑Cog score of 24, while SF-12 physical and mental health scores were 47.8 and 44.4, both below the cutoff of 50.</p><p><strong>Conclusion: </strong>Craniospinal RT is a safe and effective treatment for adult patients with medulloblastoma. Future treatment strategies should aim to deintensify therapy by limiting radiation to the local tumor bed in selected low-risk patients and by identifying favorable molecular subgroups for observation after surgery. Advanced techniques and targeted therapies can further reduce toxicity while maintaining strong oncologic outcomes and enhancing quality of life.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125974","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 PD-1 and PD-L1 block with chemotherapy in borderline resectable and unresectable stage III NSCLC: paradigm shift or evidence-poor hype?]","authors":"J Walter, U Nestle, F Weykamp","doi":"10.1007/s00066-025-02457-1","DOIUrl":"https://doi.org/10.1007/s00066-025-02457-1","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081607","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":"Which is the best timing to assess response after chemoradiation in locally advanced cervical cancer (BRILACC)?","authors":"Rosa Autorino, Gabriella Macchia, Luca Russo, Nicola Dinapoli, Valentina Lancellotta, Nicolò Bizzarri, Maria Gabriella Ferrandina, Maura Campitelli, Viola De Luca, Roberta Giannini, Raffaella Michela Rinaldi, Evis Sala, Benedetta Gui, Maria Antonietta Gambacorta","doi":"10.1007/s00066-025-02463-3","DOIUrl":"https://doi.org/10.1007/s00066-025-02463-3","url":null,"abstract":"<p><strong>Purpose: </strong>The goal is to investigate the best time point for assessing radiological complete response after exclusive chemoradiation in locally advanced cervical cancer (LACC). This is a retrospective single-center study.</p><p><strong>Materials and methods: </strong>Seventy-nine patients with LACC, stage IB3-IVA FIGO 2018 treated between January and December 2020 were retrospectively analyzed. All patients received external beam radiotherapy (45 Gy in 25 daily fractions ± simultaneous boost to lymph nodes), and interventional radiotherapy (IRT, 28 Gy/twice/weekly) with concurrent chemotherapy. The radiological complete response evaluation was examined using magnetic resonance imaging (MRI) at three timepoints: (i) before IRT, at the end of external beam radiotherapy, (ii) 3 months following the completion of IRT and (iii) 6 months after IRT. Seventy-nine patients were included.</p><p><strong>Results: </strong>At the three timepoints, the complete response rate increased with 21, 53, and 59 patients reporting a complete response at MRI scan, respectively. Seven patients with partial response at the second assessment had complete response 6 months after treatment completion, overall resulting in 80% clinical complete response.</p><p><strong>Conclusions: </strong>Our findings suggest that 6 months following the end of exclusive treatment for LACC patients is the best time to detect complete radiological response (measured by MRI scan) after chemoradiation. Waiting this period of time before conclusively assessing response would allow for the inclusion of patients who have not yet fully responded at 3 months, while avoiding the performance of salvage therapies too early.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041134","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":"Modern approaches to radiotherapy in primary cutaneous lymphomas: insights and recommendations from the DEGRO dermato-oncology working group.","authors":"Khaled Elsayad, Dora Correia, Ulrike Theiß, Andrea Baehr, Angela Besserer, Oliver Micke, Burkhard Greve, Cora Waldstein, Stefanie Corradini, Daniel Habermehl, Laila König, Kathrin Hering, Sebastian Adeberg, Hans Theodor Eich","doi":"10.1007/s00066-025-02453-5","DOIUrl":"https://doi.org/10.1007/s00066-025-02453-5","url":null,"abstract":"<p><p>The growing use of reduced-dose radiotherapy in patients with primary cutaneous lymphoma is a promising development. Nevertheless, the absence of controlled clinical trials to ascertain standardized doses for each specific type constitutes a significant impediment to the advancement of this field. This expert opinion strongly advocates for advancements in radiation oncology practice that address the unique complexities of primary cutaneous lymphoma. By refining our methodologies, we can optimize patient care and outcomes in this dynamic field.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024184","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":"[Does SBRT still have a role to play in nodal oligorecurrent prostate cancer or is ENRT with ADT the new standard? : An interpretation of the PEACE V-STORM trial].","authors":"Niklas Recknagel, Sebastian Adeberg","doi":"10.1007/s00066-025-02458-0","DOIUrl":"https://doi.org/10.1007/s00066-025-02458-0","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024175","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: Analysis and stress-test of the spatial accessibility to German radiation oncology centers.","authors":"Christoph Straube, Daniel Medenwald, Tim Holthaus","doi":"10.1007/s00066-025-02464-2","DOIUrl":"10.1007/s00066-025-02464-2","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024119","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":"From protocol to practice: long-Term outcomes of single-Fraction stereotactic body radiotherapy for primary non-Small cell lung cancer.","authors":"Kerem Tuna Tas, Phillip Lishewski, Fatima Frosan Sheikhzadeh, Edgar Smalec, Niklas Recknagel, Thomas Wündisch, Angelique Holland, Andreas Kirschbaum, Khalid Elsayad, Rita Engenhart-Cabillic, Klemens Zink, Hilke Vorwerk, Sebastian Adeberg, Ahmed Gawish","doi":"10.1007/s00066-025-02462-4","DOIUrl":"https://doi.org/10.1007/s00066-025-02462-4","url":null,"abstract":"<p><strong>Background: </strong>Single-fraction stereotactic body radiotherapy (SBRT) is an effective treatment option for patients with non-small cell lung cancer (NSCLC) who are ineligible for surgery. This study investigates long-term clinical outcomes, prognostic factors, and toxicity associated with high-dose single-fraction SBRT.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 110 patients with 116 NSCLC lesions treated with single-fraction SBRT between 2000 and 2023. Histologic subtypes included adenocarcinoma, squamous cell carcinoma, large cell carcinoma, and CT-defined suspicious lesions without histological confirmation. Local control (LC), progression-free survival (PFS), and overall survival (OS) were assessed using Kaplan-Meier and Cox regression models. Toxicity was evaluated using CTCAE v4.0.</p><p><strong>Results: </strong>The most common dose was 30 Gy, prescribed in 76.7% of lesions. Among patients who received ≥ 30 Gy, LC at 2, 3, and 5 years was 78%, 74%, and 68%; PFS was 63%, 49%, and 37%; and OS was 84%, 83%, and 60%, respectively. LC and PFS were significantly higher in patients treated with ≥ 30 Gy (p < 0.05). Acute pneumonitis occurred in 2 patients (1.8%), and 22 patients (20.0%) developed late-onset pneumonitis. Pneumonitis incidence was 26.8% in patients planned with 3D-CT, compared to 12.8% with DIBH or 4D-CT. No grade ≥ 3 toxicity was observed.</p><p><strong>Conclusion: </strong>High-dose (≥ 30 Gy) single-fraction SBRT provides excellent long-term tumor control with minimal toxicity with NSCLC. Advanced motion management techniques were associated with reduced pulmonary toxicity. A ≥ 30 Gy dose significantly improved LC, PFS, and OS. Higher Charlson Comorbidity Index (CCI) was associated with worse OS. These findings support the use of high-dose SF-SBRT in selected patients and highlight the need for individualized treatment planning. Prospective validation is warranted.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993560","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":"Diagnostic value of MRI for posttreatment surveillance of early-stage (I-II) glottic larynx cancer.","authors":"Lucas Mose, Emre Korkmaz, Miranda Visini, Roland Giger, Daniel Hendrik Schanne, Olgun Elicin","doi":"10.1007/s00066-025-02460-6","DOIUrl":"https://doi.org/10.1007/s00066-025-02460-6","url":null,"abstract":"<p><strong>Purpose: </strong>There is no uniformity across various guidelines in defining the modality and frequency of the follow-up, particularly regarding radiological imaging. The objective is to assess the diagnostic performance of magnetic resonance imaging (MRI)-based posttreatment surveillance for early-stage (I-II) glottic squamous cell carcinoma of the larynx.</p><p><strong>Methods: </strong>The follow-up of patients diagnosed with glottic squamous cell carcinoma of the larynx, treated with radiotherapy or surgery in curative intent, was analyzed over a period of 2 years posttreatment. MRI diagnostic performance metrics were calculated using clinical and post-MRI endoscopic examinations as the reference standard. MRI sequences included both anatomical and functional imaging, including diffusion-weighted imaging.</p><p><strong>Results: </strong>In total, 171 eligible MRIs were analyzed in the follow-up. Recurrences were identified with a sensitivity of 75% and a specificity of 99%. However, the positive predictive value of MRI surveillance reflects considerable uncertainty in the diagnosis of recurrences based solely on MRI findings, dropping as low as 21% in sensitivity analyses. Moreover, a notable proportion of MRIs were inconclusive.</p><p><strong>Conclusion: </strong>MRI demonstrates high specificity and acceptable sensitivity; however, the limited positive predictive value raises concerns regarding its utility as a stand-alone surveillance tool.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969661","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":"Multicenter multiplatform pattern-of-practice analysis of single-isocenter multitarget stereotactic radiosurgery.","authors":"Benedikt Thomann, Tobias Fechter, Johannes Fischer, Armin Runz, Julian Roers, Ute Ludwig, Melanie Grehn, Maximilian Grohmann, Christian Ziemann, Michael Judge, Wolfgang Baus, Michelle Grahle, Matthias Walke, Bastian Bathen, Janett Köhn, Paul Käthner, Maya Shariff, Rebecca Matthis, Jens Fleckenstein, Sascha Großmann, Tino Streller, Simon Howitz, Marlen Priegnitz, Rocco Weigel, Peter Winkler, Oliver Blanck, Daniela Schmitt, Jurgen Beck, Marcia Machein, Evangelos Pappas, Ilinca Popp, Michael Reiner, Christian P Karger, Christos Moustakis, Michael Bock, Anca-Ligia Grosu, Dimos Baltas","doi":"10.1007/s00066-025-02424-w","DOIUrl":"10.1007/s00066-025-02424-w","url":null,"abstract":"<p><strong>Purpose: </strong>Single-isocenter multitarget stereotactic radiosurgery (SIMT SRS) offers enhanced clinical efficiency for treating multiple brain metastases. However, it introduces additional uncertainties, such as off-center dose and beam profile inaccuracies, as well as quality assurance (QA) challenges, complicating its implementation. This study aims to evaluate different SIMT SRS approaches.</p><p><strong>Methods: </strong>We collected and analyzed SIMT SRS protocol and infrastructure parameters from 23 radiotherapy centers across Germany, Austria, and Switzerland, encompassing immobilization systems, computed tomography (CT) protocols, linear accelerators, treatment planning systems, beam configurations, imaging techniques, and QA practices. Consensus, deviations, and compliance with current guidelines were assessed. Subsequent studies will include on-site measurements, evaluation of treatment plan quality and delivery accuracy, and correlation of these findings with the analyzed protocols to identify potential links between protocol parameters and clinical outcomes.</p><p><strong>Results: </strong>There is consensus (at least 80% agreement) for a CT slice thickness of ≤ 1 mm, the need for six-degree-of-freedom patient setup correction, and noncoplanar treatment. There is notable variability for intrafraction imaging (used by 70%), minimum accepted planning target volume diameter (ranging from 2-10 mm), SRS QA, and general plan parameters, such as photon energy and number of treatment fields. There is also high variability in employed linear accelerator models and treatment planning systems.</p><p><strong>Conclusion: </strong>These findings highlight a lack of standardization in SIMT SRS practices. Combined with future measurements correlating protocols to treatment quality, our study will provide a foundation for recommendations to support the safe and standardized implementation of SIMT SRS.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"953-962"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601651","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}