Strahlentherapie und Onkologie最新文献

{"title":"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/s00066-024-02294-8","DOIUrl":"10.1007/s00066-024-02294-8","url":null,"abstract":"<p><p>The incidence of cervical cancer has been increasing recently, becoming an essential factor threatening patients' health. Positron emission computed tomography (PET/CT) and positron emission tomography/magnetic resonance imaging (PET/MRI) are multimodal molecular imaging methods that combine functional imaging (PET) and anatomical imaging (CT) with MRI fusion technology. They play an important role in the clinical management of patients with cervical cancer. Precision radiotherapy refers to the use of advanced intensive modulated radiotherapy (IMRT) to give different doses of radiation to different treatment areas to achieve the purpose of killing tumors and protecting normal tissues to the greatest extent. At present, pelvic target delineation is mostly based on CT and MRI, but these mostly provide anatomical morphological information, which is difficult to show the internal metabolism of tumors. PET/CT and PET/MRI combine information on biological function, metabolism and anatomical structure, thereby more accurately distinguishing the boundaries between tumor and non-tumor tissues and playing a positive guiding role in improving radiotherapy planning (RTP) for cervical cancer and evaluating treatment effect.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"507-518"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354172","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":"Efficacy of palliative hemostatic radiotherapy for tumor bleeding and pain relief in locally advanced pelvic gynecological malignancies.","authors":"Eva Meixner, Line Hoeltgen, Lisa A Dinges, Semi Harrabi, Katharina Seidensaal, Fabian Weykamp, Philipp Hoegen-Sassmanshausen, Maria Vinsensia, Laila König, Maximilian Deng, Jürgen Debus, Juliane Hörner-Rieber","doi":"10.1007/s00066-024-02319-2","DOIUrl":"10.1007/s00066-024-02319-2","url":null,"abstract":"<p><strong>Purpose: </strong>The appearance of symptomatic tumor-related vaginal bleeding and pain in advanced incurable cancer patients with pelvic gynecological malignancies remains a therapeutic challenge in oncological treatment. The aim of our analysis was to evaluate the efficacy and safety of palliative hemostatic radiotherapy.</p><p><strong>Methods: </strong>We retrospectively identified patients who had received palliative hemostatic radiotherapy (RT) at our institution between 2011 and 2023 and evaluated acute toxicity, local control, cessation of bleeding, and pain relief.</p><p><strong>Results: </strong>In total, 40 patients with a median planning target volume of 804 cm³ were treated with a median total dose of 39 Gy in 13 fractions, resulting in 6‑month and 1‑year local control rates of 66.9 and 60.8%, respectively. No higher-grade (>grade III) acute RT-induced toxicity appeared. Complete cessation of bleeding was achieved in 80.0% of all patients after a median of 16 days and pain relief was documented in 60.9% at first follow-up. 37.5% of the women required a blood transfusion and 25% an additional tamponade with local hemostatic agents. Successful stopping of bleeding was significantly less frequent in patients receiving anticoagulation concurrently with radiation and in the case of infield re-irradiation. Patients with a higher total RT dose had cessation of bleeding significantly more often, with a cut-off value of at least EQD2 (α/β = 10) = 36 Gy. The applied RT technique and planning target volume had no significant influence on the occurrence of bleeding cessation.</p><p><strong>Conclusion: </strong>Palliative hemostatic radiotherapy for locally advanced pelvic gynecological malignancies is safe and effective in achieving high control rates of hemostasis in tumor bleeding and pain relief.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"528-536"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628512","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":"Linear regression analysis for complete blood count parameters during radiotherapy.","authors":"Aniwat Berpan, Nattapatch Janhom","doi":"10.1007/s00066-024-02344-1","DOIUrl":"10.1007/s00066-024-02344-1","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the correlations between complete blood count (CBC) during radiotherapy and patient and treatment factors.</p><p><strong>Patients and methods: </strong>Data of cancer patients, including age, sex, concurrent chemotherapy (CCRT), radiotherapy dose (equivalent dose in 2‑Gy fractions with an alpha/beta value of 10 Gy, EQD2Gy10), radiotherapy location, and baseline CBC were collected. Linear regression was used to determine results during radiation. Validation data comprised 20% of the whole cohort.</p><p><strong>Results: </strong>A total of 496 radiotherapy courses and 1884 weekly CBC results during treatment were analyzed. Baseline hemoglobin (Hb) was positively associated with subsequent Hb. Each 1 g/dL increase in baseline Hb predicted a 0.73 g/dL increase in Hb during treatment (95% confidence interval [CI] 0.7-0.76). Male sex was associated with a 0.16 g/dL higher Hb (95% CI 0.04-0.29), while female sex showed the opposite trend. CCRT was associated with a 0.18 g/dL reduction in Hb (95% CI -0.33 to -0.03). Radiotherapy to the pelvis, bone, and head and neck regions resulted in Hb reductions of 0.18, 0.34, and 0.94 g/dL, respectively (95% CI -0.33 to -0.03, -0.53 to -0.15, and -1.26 to -0.62, respectively), while brain irradiation increased Hb by 0.22 g/dL (95% CI 0.05-0.38). Age, cumulative dose, and thoracic irradiation did not show a significant correlation with Hb changes. Adjusted R‑squared for the development and validation data were 0.6 and 0.71 for Hb, 0.42 and 0.11 for white blood cell count, 0.36 and 0.32 for neutrophils, 0.42 and 0.06 for absolute neutrophil count, and 0.43 and 0.36 for platelets, respectively.</p><p><strong>Conclusion: </strong>Hb levels during radiotherapy could be explained using linear regression, although they did not negatively correlate with cumulative dose.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"561-566"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955457","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":"Contouring in transition: perceptions of AI-based autocontouring by radiation oncologists and medical physicists in German-speaking countries.","authors":"Samuel M Vorbach, Florian Putz, Ute Ganswindt, Stefan Janssen, Maximilian Grohmann, Stefan Knippen, Felix Heinemann, Rami A El Shafie, Jan C Peeken","doi":"10.1007/s00066-025-02403-1","DOIUrl":"https://doi.org/10.1007/s00066-025-02403-1","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI)-based autocontouring software has the potential to revolutionize radiotherapy planning. In recent years, several AI-based autocontouring solutions with many advantages have emerged; however, their clinical use raises several challenges related to implementation, quality assurance, validation, and training. The aim of this study was to investigate the current use of AI-based autocontouring software and the associated expectations and hopes of radiation oncologists and medical physicists in German-speaking countries.</p><p><strong>Methods: </strong>A digital survey consisting of 24 questions including single-choice, multiple-choice, free-response, and five-point Likert scale rankings was conducted using the online tool umfrageonline.com (enuvo GmbH, Pfäffikon SZ, Switzerland).</p><p><strong>Results: </strong>A total of 163 participants completed the survey, with approximately two thirds reporting use of AI-based autocontouring software in routine clinical practice. Of the users, 92% found the software helpful in clinical practice. More than 90% reported using AI solutions to contour organs at risk (OARs) in the brain, head and neck, thorax, abdomen, and pelvis. The majority (88.8%) reported time savings in OAR delineation, with approximately 41% estimating savings of 11-20 min per case. However, nearly half of the respondents expressed concern about the potential degradation of resident training in sectional anatomy understanding. Of respondents, 60% would welcome guidelines for implementation and use of AI-based contouring aids from their respective radiation oncology societies. Respondents' free-text comments emphasized the need for careful monitoring and postprocessing of AI-delivered autocontours as well as concerns about overreliance on AI and its impact on the development of young physicians' contouring and planning skills.</p><p><strong>Conclusion: </strong>Artificial intelligence-based autocontouring software shows promise for integration into radiation oncology workflows, with respondents recognizing its potential for time saving and standardization. However, successful implementation will require ongoing education and curriculum adaptation to ensure AI enhances, rather than replaces, clinical expertise.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042648","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":"Initial experience with MR-guided adaptive spinal stereotactic radiotherapy: a new indication for the MR-linac.","authors":"Neris Dincer, Teuta Zoto Mustafayev, Ceren Atahan, Gorkem Gungor, Gamze Ugurluer, Mehmet Ufuk Abacioglu, Enis Ozyar, Banu Atalar","doi":"10.1007/s00066-025-02401-3","DOIUrl":"https://doi.org/10.1007/s00066-025-02401-3","url":null,"abstract":"<p><strong>Background and purpose: </strong>Stereotactic body radiotherapy (SBRT) is associated with good local control and symptom relief in the management of spinal metastases. Delivery of ablative doses and re-irradiation is challenged by spinal cord toxicity. We hypothesized that lower spinal cord doses as well as better target coverage could be yielded with stereotactic magnetic resonance-guided adaptive radiotherapy (SMART).</p><p><strong>Materials and methods: </strong>Institutional records were reviewed to retrieve patients who received online MR-guided SBRT for spinal metastases. Each fraction was reviewed to determine the necessity of adaptive planning, to identify reasons for violations that required adaptive planning, and to assess the spinal cord dose. The study also evaluated how adaptive planning contributed to reducing spinal cord doses.</p><p><strong>Results: </strong>A total of 34 patients with 61 lesions were included. The treatment intent was definitive for 47 (77.1%), palliative for 12 (19.7%), and postoperative for two (3.3%) lesions. The median prescribed Biological Equivalent Dose (BED)₁₀ was 51.3 Gy. Treatment plans often required adaptive adjustments (81.8%). Adaptive planning significantly improved target coverage (median PTV coverage 92.75% vs. 95%; p < 0.001) and reduced spinal cord D_max (median spinal cord D_max constraint: 7.3 Gy, median predicted spinal cord D_max: 7.76, and median adaptive spinal cord D_max 6.18; p < 0.001). Lesion-based median follow-up from irradiation was 7.5 months (range: 1-46 months). One-year LPFS was 94.3%. Six lesions progressed and none of the progressed lesions received a dose above the median BED₁₀ of 51.3 Gy.</p><p><strong>Conclusion: </strong>Herein we present our institutional experience with SMART for spinal bone metastases. According to our results, adaptive planning yields better target coverage as well as lower spinal cord doses compared to the predicted plan, which translates into a feasible method for delivering SBRT. Future prospective studies evaluating spinal SMART are awaited.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998304","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":"Radiotherapy of localized orbital mantle cell lymphoma: a SEER database analysis of long-term outcomes.","authors":"Pierre Loap, Youlia Kirova, Rémi Dendale","doi":"10.1007/s00066-025-02404-0","DOIUrl":"https://doi.org/10.1007/s00066-025-02404-0","url":null,"abstract":"<p><strong>Introduction: </strong>Primary orbital lymphomas are predominantly low-grade subtypes, such as extranodal marginal zone lymphomas (MALT) and follicular lymphomas, which are highly radiosensitive. Mantle cell lymphoma (MCL), although less common, is an aggressive high-grade subtype with an intermediate-to-poor prognosis. While systemic therapies are standard for MCL, data on the efficacy of radiotherapy in localized orbital MCL are limited. This study evaluates the long-term outcomes of radiotherapy for localized orbital MCL using the Surveillance, Epidemiology, and End Results (SEER) database.</p><p><strong>Materials and methods: </strong>This retrospective study analyzed cases of localized orbital MCL treated with radiotherapy between 2000 and 2021 identified in the SEER database. Demographic, clinical, and survival data were extracted. The primary endpoints were overall (OS) and cancer-specific survival (CSS), estimated using the Kapla-Meier method and Cox proportional hazards models. Statistical analyses were conducted using R software (R Foundation, Vienna, Austria), with a significance threshold set at p < 0.05.</p><p><strong>Results: </strong>Among 13,662 patients with localized primary orbital lymphomas, 63 (0.5%) cases were histologically confirmed as MCL. Of these, 35 patients (55.6%) received radiotherapy. The age-adjusted incidence rate of orbital MCL was 0.033 per 1,000,000 person-years (95% CI: 0.025-0.042). Patients were predominantly elderly (42.9% were over 80 years old) and male (male-to-female ratio of 2.18 : 1; p = 0.012). With a median follow-up of 91 months (range: 4-237 months), the median OS was 113 months. The 5‑, 10-, and 15-year OS rates were 76.5% (95% CI: 62.7-93.4%), 48.2% (32.9%-70.6%), and 42.8% (27.4%-66.9%), respectively. Median CSS was not reached, with 5‑, 10-, and 15-year CSS rates of 98.0% (95% CI: 78.0-100.0%), 83.4% (69.5%-100.0%), and 83.4% (69.5%-100.0%), respectively. Chemotherapy did not show a significant impact on survival.</p><p><strong>Conclusion: </strong>Radiotherapy achieves excellent long-term survival outcomes for localized orbital MCL, particularly in elderly and frail patients who may not tolerate systemic therapies. These findings support radiotherapy as an effective therapeutic option for this rare lymphoma subtype. Future multicenter studies are warranted to optimize radiotherapy protocols and improve patient outcomes.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054467","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":"Thymic tumors: radiotherapy experience for single institute.","authors":"Sureyya Sarihan, Aybuke Tugce Metin, Ahmet Sami Bayram, Huseyin Melek","doi":"10.1007/s00066-025-02395-y","DOIUrl":"https://doi.org/10.1007/s00066-025-02395-y","url":null,"abstract":"<p><strong>Purpose: </strong>The aim is to evaluate treatment outcomes and prognostic factors in patients with thymic epithelial tumor (TET) treated with radiotherapy (RT).</p><p><strong>Methods: </strong>Sixty-four patients were treated between 2000 and 2023. The median age was 52 years (20-83), and 81% of underwent R0 resection. The stage (s) distribution for I, II, III, and IV were 5%, 61%, 26%, and 8% by Masaoka-Koga and 63%, 11%, 17%, and 9% by TNM, respectively. WHO types A/AB/B/C and thymic neuroendocrine tumors were seen in 5%, 22%, 64%, 6%, and 3% of patients, respectively. The median RT dose was 5040 cGy (1620-6596). Survival was calculated from the beginning of RT.</p><p><strong>Results: </strong>The median follow-up was 70 months (1.5-268). The median time to recurrence was 30 months (6.5-106), seen in 23% of patients. Mean overall (OS), progression-free survival (PFS) and 5‑year local control were 141, 138 months, and 82.4%, respectively. In univariate analysis, the presence of organ invasion and TNM stage were significant as new prognostic factors for survival (p < 0.05). In multivariate analysis, the high-risk group (B2/B3/C) and another surgical center (p < 0.05) for OS, and KPS ≤ 80, thymic carcinoma, and Masaoka-Koga sIII-IV (p < 0.05) for PFS were identified as unfavorable prognostic factors.</p><p><strong>Conclusion: </strong>Recurrence in TET can occur over a longer period. In this study, 5‑year local control of 82.4% was achieved. The prognostic importance of KPS, histology, Masaoka-Koga stage, risk group, and surgical center was demonstrated. Advances in the diagnosis, staging, and treatment of TET will enable more personalized treatment.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000108","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":"Reduction of the planning target volume with daily online adaptive radiotherapy in bladder cancer.","authors":"Levente Varga, Ádám Gáldi, Domonkos Szegedi, András Herein, Dóra Pulugor, István Nahaji, László Gesztesi, Kliton Jorgo, Zoltán Takácsi Nagy, Csaba Polgár, Zsuzsa Kocsis, Tibor Major, Péter Ágoston","doi":"10.1007/s00066-025-02397-w","DOIUrl":"https://doi.org/10.1007/s00066-025-02397-w","url":null,"abstract":"<p><strong>Introduction: </strong>External radiation therapy for bladder cancer requires large planning target volumes (PTVs) due to the daily anatomy of the bladder. Online adaptive radiotherapy (oART) can reduce the PTV by considering daily anatomical changes.</p><p><strong>Patients and methods: </strong>We performed oART in 8 patients with muscle-invasive bladder cancer between June 10, 2022, and April 14, 2023, on an Ethos linear accelerator (Varian, Palo Alto, USA). Using the 496 cone-beam computed tomography (CBCT) images of the fractions, we retrospectively compared the differences in volumetric changes between oART and image-guided and intensity-modulated radiotherapy (IGRT/IMRT). According to our local protocol, for oART, a patient-specific PTV margin was created based on the intrafractional clinical target volume (CTV) changes observed during the first three fractions.</p><p><strong>Results: </strong>The average duration of treatment was 14.8 min (range 7-49 min). The average volume of the PTV with oART and IGRT/IMRT was 296.8 cm³ (range 114.5-810.4 cm³) and 416.5 cm³ (range 188.2-991.3 cm³), respectively, representing a 30% reduction with oART. This new technique resulted in an average reduction of 43.9% in the volume of unnecessarily irradiated healthy tissues. Geometrical miss of the CTV occurred in 13 fractions with IGRT/IMRT, with an average of 9.4 cm³ of missed volume (range 0.4-56.4 cm³, standard deviation [SD] 15.73), for oART in 7 fractions, with an average missed volume of 4 cm³ (range 0.4-21.2 cm³, SD: 7.6).</p><p><strong>Conclusion: </strong>The use of patient-specific margins in oART allows for reduction of the PTV and dose to healthy tissues while achieving equal or better target coverage.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032392","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":"Defining the student perspective on radiation oncology-an analysis of factors influencing medical students' decisions for specialized training.","authors":"Stefan Gravemeyer, Dogus Darici, David Rene Steike, Martina Schmitz, Hans Th Eich, Michael Oertel","doi":"10.1007/s00066-025-02396-x","DOIUrl":"https://doi.org/10.1007/s00066-025-02396-x","url":null,"abstract":"<p><strong>Purpose: </strong>The new Medical Licensing Regulations 2025 in Germany demand a longitudinal and interdisciplinary oncological curriculum for the future of medical education. Small disciplines like radiation oncology (RO) tend to be underrepresented in the general curriculum, which complicates attracting new residents and doctoral candidates to the field. To bridge this gap, our university successfully implemented a multidisciplinary training for preclinical semesters combining anatomical and RO knowledge. The following study addresses students' perceptions of RO and learning success in the setting of a mandatory preclinical course.</p><p><strong>Methods: </strong>A quantitative single-center cross-sectional study with 106 students was conducted via online questionnaire before and after a 1-week semester course in anatomy and RO. The analysis was conceptualized using descriptive statistical methods and the expectancy-value model according to Eccles and Wigfield.</p><p><strong>Results: </strong>Overall, 106 (73 female, 33 male) students with a mean age of 21.8 years took part in the first survey. Advanced courses during finals and gender had no effect on interest in RO. However, it could be shown that the understanding of RO (p < 0.0001), knowledge about patients who need to be referred to RO (p < 0.0001), and the interest in specialty training in RO (p < 0.0001) significantly increased during the course. The students' perceptions of specialty training in RO remained stable before and after the course.</p><p><strong>Conclusion: </strong>This is the first study on the influence factors for students' decisions to pursue a specialized training in RO. Students' expectations regarding a good specialty training are well represented in RO, and the implementation of preclinical courses significantly increases the knowledge about RO and the level of interest regarding a specialty training in RO.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015431","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":"Intensity modulated radiation therapy in prostate cancer-Better survival with higher total dose?","authors":"Artem Trofymov, Thomas Bschleipfer, Thomas Aigner, Gerhard G Grabenbauer","doi":"10.1007/s00066-025-02392-1","DOIUrl":"https://doi.org/10.1007/s00066-025-02392-1","url":null,"abstract":"<p><strong>Background and purpose: </strong>For patients with intermediate and high-risk prostate cancer, radiation treatment is a well-established alternative to surgery. Modern techniques, such as intensity-modulated radiation therapy and volumetric modulated arc therapy, allow for precise dose escalation to the tumor while minimizing exposure to surrounding healthy tissues. The purpose of this analysis was to assess the safety and efficacy of two different radiation treatment protocols (high dose vs low dose) in prostate cancer patients across all risk categories.</p><p><strong>Patients and methods: </strong>Between 2015 and 2021, a total of 300 consecutive patients with localized adenocarcinoma of the prostate underwent intensity-modulated radiation therapy and volumetric modulated arc therapy at this institution. The study's endpoints were overall survival, prostate cancer specific overall survival, metastases-free survival, biochemically no evidence of disease survival rates as well as acute and long-term toxic effects. Influence of patient- and treatment-related parameters, including risk stratification (low and medium vs. high risk), radiation therapy dose levels (< 76 Gy vs. ≥ 76 Gy), radiation therapy duration (≤ 51 days vs. > 51 days), treatment with or without elective node irradiation, and the use of concurrent androgen deprivation therapy was evaluated by the log-rank-test and using multivariate Cox-analysis.</p><p><strong>Results: </strong>Overall survival, prostate cancer specific overall survival, metastases-free survival and biochemically no evidence of disease survival rates were 88%, 96%, 94%, 92% and 56%, 76%, 90%, 75% at 5 and 10 years, respectively. Univariate analysis identified a significant impact of total dose and androgen deprivation therapy. Overall survival rates for patients with a total radiation dose ≥ 76 Gy were 92% and 59% at 5 and 10 years, respectively, in comparison with patients receiving a total dose of < 76 Gy having a 5-year overall survival of 82% and a 10-year of overall survival 52% (p=0.012). Androgen deprivation therapy had an impact on overall survival with a 5-year of 90% and a 10-year of 57% survival rates, in comparison to a group without androgen deprivation therapy that had a significantly lower 5-year overall survival of 79.8% and a 10-year overall survival of 23.8% (p=0.041). In multivariate analysis, total radiation dose remained of significant impact on overall survival (p=0.022) and risk grouping (p=0.026) on biochemically no evidence of disease survival. Regarding toxicity, Grade II and III late genitourinary toxicity was observed in 13 patients (4.3%), and late gastrointestinal toxicity of similar grade affected 12 patients (4%) in the cohort.</p><p><strong>Conclusion: </strong>Data from this retrospective analysis underscore the highly relevant influence of total dose in contemporary radiation treatment of patients with prostate cancer.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014209","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}