Strahlentherapie und Onkologie最新文献

{"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":"https://doi.org/10.1007/s00066-025-02384-1","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-27","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":"Advantages of 3D printed patient-individual moulds in brachytherapy for facial skin cancer.","authors":"Jörg Licher, Julia Achenbach, Janett Köhn, Markus Diefenhardt, Maximilian Fleischmann, Claus Rödel, Nikolaos Tselis, Ulla Ramm, Christian Scherf","doi":"10.1007/s00066-025-02372-5","DOIUrl":"https://doi.org/10.1007/s00066-025-02372-5","url":null,"abstract":"<p><strong>Purpose: </strong>Facial skin cancer of 42 elderly frail patients was treated with individualised 3D-printed mould applicators for high-dose-rate (HDR) brachytherapy. The dosimetric outcome was compared to conventionally manufactured individual moulds used before.</p><p><strong>Methods: </strong>Tumour-adapted HDR brachytherapy source paths were pre-planned and dosimetrically optimised in the brachytherapy treatment planning system (TPS) using computed tomography (CT) data and considered in the design of the patient-individual moulds. Dosimetric outcome for the planning target volumes and organs at risk were statistically evaluated and compared for pre-planning, final clinical treatment planning with TG-43 formalism and retrospective tissue, material and CT density related TG-186 calculations.</p><p><strong>Results: </strong>Pre-planning allows reliable brachytherapy source paths design to achieve intended dosimetric clinical goals. The 3D-printed patient-specific moulds show a clear advantage in the dosimetric coverage of the target volume (improving D₉₀ from 98.3% to 104.3%) and the protection of the relevant organs at risk (reduction up to 30% of maximum Dose). With the 3D-printed moulds only minor deviations were observed for TG-43 and TG-186 dose recalculations of the treated plans.</p><p><strong>Conclusion: </strong>Customised 3D printed moulds offer a safe and efficient technique to treat facial skin cancer in critical locations and complex clinical situations with HDR brachytherapy. The two-step planning process results in reliable PTV dose coverage and efficient sparing of eye lenses and eyeballs. Dosimetric outcome and interfractional position reproducibility with 3D printed moulds were superior to conventionally manufactured facial moulds with respect to the clinical goals.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504294","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 and toxicity of stereotactic radiotherapy combined with third-generation EGFR-TKIs and immunotherapy in patients with brain metastases from non-small cell lung cancer.","authors":"Xiaoxuan Tao, Qichang Gao, Yiyang Chen, Nannan Cai, Chuncheng Hao","doi":"10.1007/s00066-024-02360-1","DOIUrl":"https://doi.org/10.1007/s00066-024-02360-1","url":null,"abstract":"<p><strong>Objective: </strong>Stereotactic radiotherapy (SRT) is fast gaining attention as a preferred treatment alternative for patients with brain metastases (BM) from non-small cell lung cancer (NSCLC). In this study, we examined the efficacy and safety of combining SRT with immunotherapy (IT) and targeted therapy (TT), either separately or concurrently with the aim to formulate an optimal therapeutic regimen for patients with NSCLC BM.</p><p><strong>Methods: </strong>The combination therapy were comprised of IT and TT agents. For the SRT-combined TT agents group, TT was limited to third-generation EGFR-TKIs. The administration of these drugs within 30 days before or after SRT was defined as combination therapy. The primary endpoint was 1-year progression-free survival (PFS), which was evaluated by a blinded independent review committee and categorized into local recurrence at the radiation site and the emergence of new distant intracranial metastases. Secondary endpoints included confirmed intracranial objective response rate (IORR) and intracranial disease control rate in the overall population. Post-treatment grading was performed according to CTCAE, and the levels of radiation necrosis were differentiated.</p><p><strong>Results: </strong>The 266 patients with NSCLC BM were categorized into the following four groups based on their treatment methods: SRT alone, SRT combined with IT, SRT combined with third-generation EGFR-TKIs, and SRT combined with both IT and TT. For the local radiation range, the 1‑year PFS of these four groups were 77.89% (P = 0.239), 88.75% (P = 0.266), 88.01% (P = 0.210), and 91.97% (P = 0.057), respectively. For new intracranial metastases outside of the radiotherapy site, the corresponding values were 63.96% (P = 0.039), 74.17% (P = 0.258), 88.70% (P = 0.024), and 87.81% (P = 0.015), respectively. By the end of the study period, the IORR increased from 32% with SRT alone to 46% in the IT group, 58% in the TT group, and 61% in the SRT combined with both the IT and TT groups. However, the group that received SRT in combination with IT and TT exhibited a higher occurrence rate of grade 3 adverse events, and a statistically significant difference was observed in grade 3 radiation necrosis.</p><p><strong>Conclusion: </strong>For NSCLC BM, IT, TT, or both together with SRT increased the distant intracranial tumor control. Nonetheless, combining SRT with both IT and TT increased the occurrence rate of acute adverse events. Thus, while SRT provided good local control independently, the incidence of symptomatic RN was low.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504239","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":"https://doi.org/10.1007/s00066-025-02383-2","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-24","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 EMBARK trial: The use of enzalutamide in biochemically recurrent prostate cancer after primary therapy].","authors":"Mohamed Shelan, Etienne Mathier, Daniel M Aebersold, Thomas Wiegel","doi":"10.1007/s00066-025-02371-6","DOIUrl":"https://doi.org/10.1007/s00066-025-02371-6","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469334","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":"FBXL18 increases cell proliferation and reduces cell radiosensitivity in esophageal squamous cell carcinoma.","authors":"Yahui Kang, Ning Ge, Xiaolong Yuan, Bihong Zhan, Hongbo Zhang","doi":"10.1007/s00066-025-02373-4","DOIUrl":"https://doi.org/10.1007/s00066-025-02373-4","url":null,"abstract":"<p><strong>Background: </strong>Esophageal squamous cell carcinoma (ESCC) is one of the most common malignant tumors worldwide. In this study, we aimed to investigate the pathophysiological mechanism through which F‑box and leucine-rich repeat protein 18 (FBXL18) promotes the progression of ESCC.</p><p><strong>Methods: </strong>ESCC cell lines KYSE150 and TE‑1 were infected with PLVX-FBXL18 or shFBXL18-derived lentivirus to overexpress or knock down FBXL18. A Cell-Counting Kit 8 and colony-forming assay were used to assess cell viability and proliferation. Cells were irradiated with varying doses of X‑ray (IR) to determine whether FBXL18 influenced the radiosensitivity of ESCC cells. KYSE450 cells, stably transduced with shNC or shFBXL18-derived lentivirus, were injected into nude mice to assess whether FBXL18 affected ESCC tumor growth. KYSE150 and TE-1 cells overexpressing FBXL18 were lysed for Western blot analysis to evaluate protein expression.</p><p><strong>Results: </strong>FBXL18 overexpression enhanced cell viability and colony formation, and proliferation of ESCC cells. In contrast, FBXL18 knockdown inhibited tumor growth in vivo. Additionally, FBXL18 overexpression reduced the radiosensitivity of ESCC cells. Mechanistically, FBXL18 was found to exert its effects by suppressing the expression of FBXL7 in ESCC cells.</p><p><strong>Conclusion: </strong>FBXL18 promotes cell proliferation and diminishes radiosensitivity in ESCC cells. Most likely, it exerts its pro-tumorigenic effects by downregulating FBXL7.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459646","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":"High radiation dose in chemoradiotherapy followed by immunotherapy with durvalumab in patients with stage III non-small cell lung cancer does not increase risk for pneumonitis.","authors":"Felix Schragel, Melanie Matousek, Christoph Resl, Gudrun Kreye, Nguyen-Son Le, Peter Errhalt, Petra Georg, Klaus Hackner","doi":"10.1007/s00066-025-02369-0","DOIUrl":"https://doi.org/10.1007/s00066-025-02369-0","url":null,"abstract":"<p><strong>Purpose: </strong>Consolidation immunotherapy with immune checkpoint Inhibitor (ICI) Durvalumab is an effective treatment for inoperable stage III non-small cell lung cancer (NSCLC) patients with a PD-L1 expression ≥ 1% after definitive curative concurrent chemoradiotherapy (CCRT). While this approach is widely used as standard therapy, it carries an increased risk of immune-related and radiation-induced pneumonitis. Currently, there is no data on pneumonitis in patients receiving CCRT with an overall dose of 70 Gy (Gy) compared with the standard protocol of 60 Gy ± 10% in this setting.</p><p><strong>Methods: </strong>This study analyzed retrospective data from 39 patients with unresectable NSCLC treated with CCRT. Patients received either 70 Gy (n = 29) or lower than 70 Gy total dose (n = 10) in 2 Gy fractions. Cases of pneumonitis were further classified as RI‑P (Radio-induced Pneumonitis) and ICI‑P (ICI Pneumonitis) based on clinical and radiological findings.</p><p><strong>Results: </strong>Of the 39 patients, 15 (38.5%) developed pneumonitis, with 10 out of 29 (34.5%) in the 70 Gy group and five out 10 (50%) in the < 70 Gy group. There was no significant difference in pneumonitis and in occurrence of ICI‑P vs. RI‑P (26.7% vs. 73.3%) within both groups. The 70 Gy group showed a significant benefit in mortality (p = < 0.001). Overall survival (OS) differed significantly between groups (p =0.028).</p><p><strong>Conclusions: </strong>70 Gy radiation dose for CCRT followed by durvalumab is a safe regimen and may provide clinical benefits in NSCLC patients compared to lower doses. Pneumonitis incidence aligns with previous literature. The higher dose is associated with improved overall survival, and reduced disease progression, potentially due to a longer consolidation time.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411106","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":"A new GPU-based Monte Carlo code for helium ion therapy.","authors":"Shijun Li, Ning Gao, Bo Cheng, Junyi Liu, Yankui Chang, Xi Pei, Xie George Xu","doi":"10.1007/s00066-024-02357-w","DOIUrl":"https://doi.org/10.1007/s00066-024-02357-w","url":null,"abstract":"<p><strong>Purpose: </strong>This work presents an effort to extend the capabilities of the previously introduced GPU-based Monte Carlo code ARCHER for helium ion therapy.</p><p><strong>Methods: </strong>ARCHER performs helium ion transport simulations in voxelized geometry, covering kinetic energy levels up to 220 MeV/u. The physical processes are modeled using a class II condensed-history algorithm, considering ionization, energy straggling, multiple scattering, and elastic and inelastic nuclear interactions. A new nuclear-event-repeat algorithm is proposed to generate inelastic nuclear reaction products. Secondary protons, deuterons, tritons, and ³He particles are tracked, while other particles either deposit their energy locally or are ignored. The code is developed under the compute unified device architecture (CUDA) platform to improve computational efficiency. Validations are conducted by benchmarking our code against TOPAS in different phantoms.</p><p><strong>Results: </strong>Dose distribution comparisons demonstrate strong agreement between our code and TOPAS. The mean point-by-point local relative errors in the region where the dose exceeds 10% of the maximum dose range from 0.25% to 1.31% for all phantoms. In the strict 1%/1 mm criterion, gamma passing rates for a head-neck case, chest case, and prostate case are 99.8%, 96.9%, and 99.6%, respectively. Except for the lung phantom, ARCHER takes less than 10 s to simulate 10 million primary helium ions using a single NVIDIA GeForce RTX 3080 card (NVIDIA Corporation, Santa Clara, USA), while TOPAS requires several minutes on a computational platform with two Intel Xeon Gold 6348 CPUs (Intel Corporation, Santa Clara, USA) with 56 cores.</p><p><strong>Conclusion: </strong>This work presents the development and benchmarking of the first GPU-based dose engine for helium ion therapy. The code has been proven to achieve high levels of accuracy and efficiency.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370998","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":"Radio(chemo)therapy in anal cancer: evaluation of sex-specific disparities across AJCC stages.","authors":"F Fuchs, P Rogowski, M Rottler, M A Shouman, K Heinrich, F Kühn, C Belka, K Unger, F Walter","doi":"10.1007/s00066-025-02368-1","DOIUrl":"https://doi.org/10.1007/s00066-025-02368-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate sex differences in anal squamous cell carcinomas (ASCC), with a particular focus on the prognostic significance of the American Joint Committee on Cancer (AJCC) 9th edition staging system for oncological outcome.</p><p><strong>Methods: </strong>A retrospective analysis was conducted in 188 patients with histologically confirmed ASCC who underwent definitive (chemo)radiotherapy between 2004 and 2020. Patient- and tumor-related data were collected. Tumor stage groups were classified according to the AJCC 9th edition. Overall survival (OS), disease-free survival (DFS), freedom from recurrence (FFR), and colostomy-free survival (CFS) were analyzed using the Kaplan-Meier method for univariate testing and Cox regression models for multivariate analysis. Differences between sexes were assessed.</p><p><strong>Results: </strong>The cohort included 134 females and 54 males, with a median follow-up of 83 months. Females exhibited significantly better OS (p = 0.01), DFS (p = 0.01), and CFS (p = 0.03). For male patients, there was a clear trend towards better OS (p = 0.08), DFS (p = 0.10), and FFR (p = 0.09) in earlier tumors as well as significantly better CFS (p = 0.04). In contrast, in the female subgroup, there were no significant differences in OS (p = 0.64), DFS (p = 0.52), and CFS (p = 0.25) with respect to tumor stage. In multivariate analysis, male sex, older age, and advanced tumor stages were significant risk factors for poorer OS, DFS, and CFS.</p><p><strong>Conclusion: </strong>This study highlights significant sex differences in ASCC prognoses, with females showing better survival outcomes. The prognostic value of the AJCC 9th edition staging system differs between sexes; thus, we support the inclusion of sex as a prognostic factor in staging systems.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365985","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":"Implant geometry and detection rates of prostate fiducial markers after transrectal ultrasound-guided perineal implantation for image-guided 6D-tracking in robotic stereotactic body radiotherapy.","authors":"Arne Grün, Katharina Heil, Daniel Zips, Goda Kalinauskaite, Dirk Böhmer","doi":"10.1007/s00066-024-02363-y","DOIUrl":"https://doi.org/10.1007/s00066-024-02363-y","url":null,"abstract":"<p><strong>Purpose: </strong>Fiducial markers (FM) are essential in prostate robotic stereotactic body radiotherapy (SBRT). Accuray® (Madison, WI, USA) provides an implantation guideline for reliable detection. We report on complication rates and analyze how the geometrical implantation quality correlated with subsequent detection rates. We also investigated whether factors such as single vs. double FM, body mass index (BMI), prostatic gland volume, and implantation-to-treatment interval were predictive for geometry and detection quality.</p><p><strong>Methods: </strong>A retrospective analysis of 64 patients receiving transrectal ultrasound (TRUS)-guided transperineal implantation of ≥ 3 prostate FM and robotic SBRT between January 2011 and May 2021 was performed. Adverse events (AE) were classified according to the Society of Interventional Radiology (SIR) classification system. Digitally reconstructed radiographs (DRR) and the planning CT constituted the basis for implant geometry calculations. Marker detection rates were obtained from the Synchrony® (Accuray®) log.</p><p><strong>Results: </strong>Complication rates were low, with mostly mild AE. Double FM significantly improved the rate of obtaining an optimal implantation geometry. High FM detection rates during treatment could be achieved independent of implantation geometry and type of FM. BMI and prostatic gland volume did not correlate with geometry and detection quality. An implantation-to-treatment interval of > 42 days was predictive for lower detection rates.</p><p><strong>Conclusion: </strong>Transperineal intraprostatic FM implantation is a safe procedure. We recommend the use of double markers for reduction of trauma (two punctures instead of four) and, hence, increased patient comfort. Double FM were significantly predictive for achieving an optimal implantation geometry, which was borderline significant for improved marker detection rates over the course of the five-fraction treatment.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365983","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}