Strahlentherapie und Onkologie最新文献

{"title":"Anatomical-molecular interaction in glioblastoma: subventricular zone involvement and MGMT-related survival benefit.","authors":"Flavio Donnini, Alessandro Bonzani, Pierpaolo Pastina, Giuseppe Battaglia, Armando Perrella, Giulio Bagnacci, Salvatore Chibbaro, Alfonso Cerase, Maria Antonietta Mazzei, Giuseppe Minniti, Paolo Tini","doi":"10.1007/s00066-026-02600-6","DOIUrl":"https://doi.org/10.1007/s00066-026-02600-6","url":null,"abstract":"<p><strong>Purpose: </strong>Both MGMT promoter methylation and subventricular zone (SVZ) involvement influence glioblastoma prognosis. We investigated whether SVZ involvement modifies the prognostic impact of MGMT promoter methylation.</p><p><strong>Methods: </strong>We retrospectively analysed 117 adults with IDH-wildtype glioblastoma (CNS WHO 2021) treated with chemoradiotherapy (Stupp protocol) between 2019 and 2024. MGMT methylation was assessed by pyrosequencing (cut-off ≥10%). SVZ involvement was defined as overlap between the gross tumour volume and a 5-mm expansion from the lateral ventricular walls, including temporal horns. Overall (OS) and progression-free survival (PFS) were analysed using multivariable Cox models with an MGMT × SVZ interaction term and two sensitivity analyses.</p><p><strong>Results: </strong>SVZ involvement occurred in 45 patients (38%). Median PFS and OS were 11 and 15 months. Median OS was 32 months in MGMT-methylated/SVZ-negative vs 13 months in MGMT-methylated/SVZ-positive cases (pairwise log-rank p=0.001). On multivariable analysis, MGMT methylation remained protective (HR 0.50, p=0.008), whereas SVZ involvement lost independent significance (p=0.16). The MGMT × SVZ interaction was significant for OS (HR 2.62, 95% CI 1.12-5.40; p=0.020) but not PFS (p=0.42), persisting across sensitivity analyses. Recurrences were predominantly in-field (72.0-81.8%).</p><p><strong>Conclusion: </strong>SVZ involvement attenuates the survival benefit conferred by MGMT methylation, supporting combined anatomical-molecular stratification. Given the cohort size and lack of PFS effect, these findings are hypothesis-generating and do not justify modifying radiotherapy target volumes based on SVZ involvement alone.</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":"149031357","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 using boron neutron capture therapy for recurrent oral squamous cell carcinoma: the impact of tumor volume and early response on survival.","authors":"Kanako Takayama, Ichiro Seto, Takashi Ono, Yoshiaki Takagawa, Shinya Komori, Ryohei Kato, Akihiko Takeuchi, Yuhei Yamazaki, Tomoaki Motoyanagi, Yuki Narita, Shunsuke Komatsu, Takahiro Kato, Yoshihiro Takai","doi":"10.1007/s00066-026-02601-5","DOIUrl":"https://doi.org/10.1007/s00066-026-02601-5","url":null,"abstract":"<p><strong>Purpose: </strong>Re-irradiation for recurrent oral cancer remains clinically challenging due to limited treatment efficacy and severe toxicity. In this study, we evaluated the clinical outcomes of boron neutron capture therapy (BNCT) and explored prognostic factors associated with survival in oral squamous cell carcinoma (OSCC).</p><p><strong>Methods: </strong>We conducted a retrospective single-institution cohort study of 45 patients with recurrent OSCC treated with accelerator-based BNCT between June 2020 and December 2022. Overall survival (OS), local control (LC), and progression-free survival (PFS) were estimated using the Kaplan-Meier method. Prognostic factors were assessed using Cox proportional hazards models.</p><p><strong>Results: </strong>The objective response rate was 80%. At a median follow-up of 25 months, the 2‑year OS, LC, and PFS rates were 51.1%, 31.8%, and 22.2%, respectively. In the univariate analysis, tumor volume was associated with OS (p = 0.036). Exploratory analyses suggested that tumor volumes ≥ 20 cm³ may be associated with inferior OS, and ≥ 25 cm³ with inferior OS and LC (p < 0.05). Patients achieving complete response (CR) within 90 days had better OS than those without CR (HR, 3.73; 95% CI, 1.50-9.30; p = 0.005). Grade ≥ 3 acute mucositis occurred in 49% of patients, and late grade ≥ 3 osteoradionecrosis occurred in 10%.</p><p><strong>Conclusion: </strong>BNCT may be an option for selected patients with recurrent OSCC after prior irradiation. Favorable responses and OS were observed, although LC remained limited and toxicities required careful management. Baseline tumor volume warrants further study for survival risk stratification, while early response may aid prognostic assessment.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025911","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 tumor ecosystem as a factor influencing efficacy and resistance to avelumab plus radiochemotherapy in head and neck cancer].","authors":"Clara Reichardt, Tina Jost","doi":"10.1007/s00066-026-02593-2","DOIUrl":"https://doi.org/10.1007/s00066-026-02593-2","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991272","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":"Intraoperative or postoperative radiotherapy boost in high-risk breast cancer: a matched-pair analysis.","authors":"Gustavo R Sarria, Cas Dejonckheere, Jorge Fernandez, Jose Burgos, Adela Heredia, Eleni Gkika, Gustavo J Sarria, Paola Fuentes-Rivera","doi":"10.1007/s00066-026-02592-3","DOIUrl":"https://doi.org/10.1007/s00066-026-02592-3","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal boost technique following breast-conserving surgery for patients with high-risk early breast cancer remains controversial. This study compared oncologic outcomes following an intraoperative radiotherapy (IORT) boost using low-energy X‑rays with those of a conventional external beam radiotherapy (EBRT) boost in a matched-pair cohort.</p><p><strong>Methods: </strong>Patients treated with breast-conserving surgery followed by either an upfront IORT boost (20 Gy prescribed to the applicator surface) or a postoperative EBRT boost (16 Gy in 8 fractions), sequentially after whole-breast radiotherapy, between 2014 and 2019 were retrospectively identified from a prospectively maintained institutional database. Whole-breast irradiation was delivered after IORT using either conventional or moderately hypofractionated schedules according to institutional practice. The primary endpoint was ipsilateral breast tumour recurrence (IBTR). Secondary endpoints included nodal recurrence, distant metastasis, overall survival (OS), and breast cancer-specific survival (BCSS). Time-to-event outcomes were estimated using the Kaplan-Meier method, whereas treatment comparisons were performed using Cox proportional hazards regression with robust sandwich variance estimates clustered by matched pair.</p><p><strong>Results: </strong>Following 1:1 matching, 400 patients (200 per group) were included. After a median follow-up of 58 months, the cumulative incidence of local recurrence was 3.5% and 2.0%, respectively, with no statistically significant difference between treatment groups (HR 1.80, 95% CI 0.58-5.58; p = 0.312). Likewise, no significant differences were observed for nodal recurrence-free survival (HR 0.98, 95% CI 0.19-5.16; p = 0.980), distant metastasis-free survival (HR 0.92, 95% CI 0.38-2.23; p = 0.859), breast cancer-specific survival (HR 0.79, 95% CI 0.30-2.10; p = 0.634), or overall survival (HR 1.19, 95% CI 0.59-2.40; p = 0.636).</p><p><strong>Conclusions: </strong>In this matched-pair analysis, an intraoperative low-energy X‑ray boost achieved oncologic outcomes comparable to those of a conventional postoperative EBRT boost in patients undergoing breast-conserving therapy for high-risk early breast cancer. These findings support IORT boost as an effective and well-tolerated alternative that may simplify treatment delivery without compromising long-term oncologic outcomes.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991341","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":"Cervical spine osteoradionecrosis complicated by pyogenic spondylitis, quadriplegia, and fatal hemorrhage following postoperative radiotherapy for laryngeal carcinoma: a case report.","authors":"Dan Wang, Jingyan Wang, Zhonglu Liu, Xicheng Song","doi":"10.1007/s00066-026-02590-5","DOIUrl":"https://doi.org/10.1007/s00066-026-02590-5","url":null,"abstract":"<p><strong>Background: </strong>Cervical spine osteoradionecrosis (ORN) is a rare but serious complication after head and neck radiotherapy. It may be complicated by secondary infection, leading to neurological impairment and severe vascular complications. We report a case of cervical spine ORN occurring 7 years after postoperative adjuvant radiotherapy for laryngeal carcinoma.</p><p><strong>Case presentation: </strong>A 70-year-old man with a history of poorly controlled type 2 diabetes mellitus and hypertension had previously undergone partial laryngectomy and neck dissection followed by postoperative helical tomotherapy for glottic laryngeal carcinoma. Seven years later, he presented with neck pain, fever, and progressive weakness of all four limbs. Cervical CT and MRI showed destructive changes of the C4-C7 vertebral bodies, gas in the C5/6 intervertebral space and prevertebral soft tissues, and findings suggestive of infectious involvement. Blood culture yielded Streptococcus constellatus. A diagnosis of cervical spine ORN complicated by pyogenic spondylitis, cervical spinal cord injury, and quadriplegia was made. The patient underwent tracheotomy, neck exploration, incision and drainage of a deep neck abscess, and debridement of necrotic tissue. Although infection control and partial neurological improvement were achieved, he subsequently developed recurrent massive oral and nasal hemorrhage and ultimately died of hemorrhagic shock.</p><p><strong>Conclusions: </strong>This case highlights the need for continued vigilance for delayed cervical spine ORN and secondary infection during long-term follow-up after head and neck radiotherapy. In patients presenting with new-onset neck pain, fever, or neurological deficits, early evaluation with CT, MRI, and, when vascular involvement is suspected, CTA should be performed to facilitate timely intervention.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983655","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":"Image-guided high-dose-rate brachytherapy after short-course external beam radiotherapy for elderly/frail rectal cancer patients.","authors":"Alexander Kristen, Nikolaos Tselis, Markus Diefenhardt, Armin Wiegering, Jörg Trojan, Hendrik Dapper, Christian Scherf, Ulla Ramm, Jörg Licher, Claus Rödel, Emmanouil Fokas, Maximilian Fleischmann","doi":"10.1007/s00066-026-02589-y","DOIUrl":"https://doi.org/10.1007/s00066-026-02589-y","url":null,"abstract":"<p><strong>Purpose: </strong>For elderly and frail patients with rectal cancer, unfit for radical surgery or extensive chemoradiation schedules, radiotherapy dose escalation by use of high-dose-rate brachytherapy (HDR-BT) may be an alternative organ-preserving approach.</p><p><strong>Methods: </strong>15 elderly/frail patients (median age, 83 years; ECOG 1‑2: 80%) with histologically confirmed rectal adenocarcinoma (T1-3, N0-1, M0; UICC stage I-IIIB) were treated with definitive radiotherapy consisting of external beam radiation therapy (EBRT) of 30-39 Gy in 10-13 fractions, followed by image-guided endorectal HDR-BT with 12-24 Gy in 2-3 fractions. Acute and late toxicity of combined EBRT and HDR-BT was recorded according to CTCAE v5.0. Initial tumor response (clinical complete response, cCR, near clinical complete response, ncCR, and incomplete response, IR) and long-term disease control were assessed using clinical examination, endoscopy, and magnetic resonance imaging.</p><p><strong>Results: </strong>Median follow-up was 21 (range, 9-43) months. Six weeks after completion of EBRT + HDR-BT, cCR (n = 6) or ncCR (n = 6) was confirmed in 12/15 patients (80%), 3 patients (20%) had IR. Local regrowth after initial (n)cCR was observed in 4 patients (33%). A total of 4/15 patients (27%) developed distant metastases (2 with IR, 2 with (n)cCR). Most common acute toxicities were mild/moderate proctitis (grade 1-2) in 67%, and mild grade 2 cystitis in 27%. Three patients (20%), of whom two were receiving oral anticoagulation, experienced late grade 3 rectal bleeding, requiring blood transfusion. One patient developed grade 3 rectal ulcer with necrosis treated with rectal amputation.</p><p><strong>Conclusions: </strong>HDR-BT dose escalation after initial EBRT represents a feasible non-operative treatment option for patients unfit for surgery with promising long-term local control. The incidence of late grade 3 rectal bleeding, especially in patients receiving concomitant oral anticoagulation, requires careful patient selection, and further dose and treatment optimization (as implemented in the upcoming ACO/ARO/AIO-22 trial).</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971356","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":"Trends in radiation oncology between 2015 and 2022: report from a German university radio-oncology department.","authors":"M Diefenhardt, D Imhoff, N Tselis, C Rödel, D Martin","doi":"10.1007/s00066-026-02541-0","DOIUrl":"https://doi.org/10.1007/s00066-026-02541-0","url":null,"abstract":"<p><strong>Purpose: </strong>How have the demographics of radiotherapy patients changed between 2015 and 2022? What was the impact of the pandemic, of modified multidisciplinary therapy concepts, and of structural changes on our patient cohort?</p><p><strong>Methods: </strong>We analyzed the data of all patients who underwent computed tomography-guided radiotherapy or ultrasound-planned high dose rate prostate brachytherapy at our department between 2015 and 2022. We examined tumor diagnoses in terms of frequency, age of the patients and the distance between patients' place of residence and our department.</p><p><strong>Results: </strong>A total of 8842 patients underwent radiotherapy at our clinic between 2015 and 2022. The median age at treatment increased from 62 years in 2015 to 64 years in 2022. Within the entire cohort, 18% underwent metastasis-directed radiotherapy, 13% had radiotherapy for head and neck tumors, and 12% for breast or prostate cancer. Skin cancer treatments increased in frequency by 79% during study period, while prostate treatments rose by 10%. Overall, 47% of all patients lived within a 10-km radius of our clinic. Patients who received brachytherapy for cervical or endometrial cancer travelled significantly further. During the national epidemic emergency (03/2020 to 11/2021), there was no significant change in the long-term average number of patients or the proportion of cancer types.</p><p><strong>Conclusion: </strong>There has been a significant increase in radiotherapy treatments for skin cancer, alongside an aging patient population. Although we primarily act as a local radiotherapy partner, the increased travel distances for brachytherapy patients underscore the particular responsibility of a university radiotherapy department as a primary center and key provider of comprehensive cancer care.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945456","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 dose and pathological complete response rate of neoadjuvant chemoradiotherapy for esophageal squamous cell carcinoma: a model-based dose-response meta-analysis.","authors":"Yian Jiang, Tianyu Su, Qi Li, Xiaobing Feng, Mengyuan Chen, Wuan Bao, Zhiwei Ye, Xiao Dang, Yongling Ji, Yang Yang","doi":"10.1007/s00066-026-02591-4","DOIUrl":"https://doi.org/10.1007/s00066-026-02591-4","url":null,"abstract":"<p><strong>Purpose: </strong>Evidence characterizing the radiotherapy dose-response relationship to inform dose selection remains limited. Using the biologically effective dose (BED), we conducted a systematic review and model-based analysis of published cohorts to examine associations between radiation dose, pathological complete response (pCR), and overall survival (OS) in esophageal squamous cell carcinoma (ESCC) patients receiving neoadjuvant chemoradiotherapy (nCRT).</p><p><strong>Materials and methods: </strong>PubMed-indexed studies published before November 2025 were included if they enrolled ≥ 20 ESCC patients treated with nCRT and reported stratified radiotherapy dose/fractionation with pCR outcomes. Dose intensity was standardized using BED (linear quadratic model, α/β = 10 Gy). Grouped quasibinomial logistic regression models assessed the BED-pCR association after adjustment for prespecified cohort-level covariates. The cohort-level association between pCR and 2‑year OS was evaluated using weighted correlation.</p><p><strong>Results: </strong>A total of 65 studies comprising 74 dose-stratified cohorts and 5235 ESCC patients treated with nCRT were included. Multivariable analyses showed that both BED and radiotherapy technique were independently associated with pCR in ESCC patients. Within the observed BED range, for every 10-Gy increase in BED, the odds of pCR increased (odds ratio [OR] = 1.39, 95% confidence interval [CI] 1.13-1.70; P = 0.002). Compared with two-dimensional conformal radiotherapy (2D-CRT), three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT)/volumetric modulated arc therapy (VMAT) were associated with higher pCR rates. At the cohort level, pCR rates showed a positive association with 2‑year OS (weighted Pearson's r = 0.519).</p><p><strong>Conclusion: </strong>A model integrating BED and radiotherapy technique provides cohort-level estimates of pCR in ESCC patients receiving nCRT. These findings provide a quantitative framework for future prospective studies evaluating dose optimization in this setting.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913646","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":"[Pre- versus postoperative stereotactic radiotherapy for brain metastases].","authors":"Paul Jan Warnke, Eirini Moysolgou, Olaf Wittenstein","doi":"10.1007/s00066-026-02566-5","DOIUrl":"10.1007/s00066-026-02566-5","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"995-997"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593238","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":"[Evolution of metastases in non-small-cell lung cancer: preliminary results from the TRACERx-PEACE study].","authors":"Jürgen Dunst","doi":"10.1007/s00066-026-02568-3","DOIUrl":"10.1007/s00066-026-02568-3","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"1001-1002"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340333","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}