Strahlentherapie und Onkologie最新文献

{"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}

{"title":"Assessment of needle bending and tracking requirements for optimized needle placement in combined intracavitary/interstitial gynecologic brachytherapy.","authors":"Andre Karius, Vratislav Strnad, Michael Lotter, Stephan Kreppner, Ricarda Merten, Rainer Fietkau, Christoph Bert, Claudia Schweizer","doi":"10.1007/s00066-025-02367-2","DOIUrl":"https://doi.org/10.1007/s00066-025-02367-2","url":null,"abstract":"<p><strong>Purpose: </strong>Needle tracking using external prediction techniques such as optical tracking is a modern approach aimed at improving implantation accuracy in gynecologic brachytherapy. This study aims to investigate the corresponding impact of needle bending in situ and to analyze needle path deviations from the intended locations occurring in our current clinical workflow that only considers ultrasound imaging without tracking.</p><p><strong>Methods: </strong>We developed a semi-automated approach for reconstructing brachytherapy needles based on planning CTs and compared the respective accuracy to the also determined intra-observer variability of manual reconstructions. Based on this, we measured needle bending in situ for 89 patients and calculated the Euclidean distances between actual needle tips and needle tip predictions both longitudinally and laterally to the insertion direction. Furthermore, we compared actual and intended spacings between inserted needles to estimate implantation uncertainties with respect to our current clinical workflow.</p><p><strong>Results: </strong>Our developed reconstruction featured an accuracy of 0.17 ± 0.08 mm, which was improved compared to the intra-observer variability of 0.21 ± 0.11 mm. Needle bending depended strongly on needle length and ranged from 3.6 ± 2.1 mm for 100-120 mm needles up to 7.9 ± 3.0 mm for 200-220 mm needles. Deflections in the transverse direction were substantially higher than tip deviations in the longitudinal direction. Furthermore, we found deviations from an equidistant spacing between needle paths of 1.4 ± 1.2 mm in the transverse direction.</p><p><strong>Conclusion: </strong>Inserting brachytherapy needles can be substantially affected by transverse needle bending in situ, which should therefore be corrected for in prediction approaches such as optical tracking.</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":"143365981","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":"Potential radiotherapy-related reactivation of immune checkpoint inhibitor hepatitis.","authors":"Kakharman Yesmembetov, Cennet Sahin, Mohamad Murad, Marie-Luise Berres, Alexander Koch, Martin von Websky, Florian Vondran, Philipp Bruners, Michael Eble, Ahmed Allam Mohamed","doi":"10.1007/s00066-024-02361-0","DOIUrl":"https://doi.org/10.1007/s00066-024-02361-0","url":null,"abstract":"<p><p>This report details the reactivation of immune checkpoint inhibitor (ICI)-related autoimmune hepatitis triggered by stereotactic body radiation therapy (SBRT) in a 55-year-old male with hilar cholangiocellular carcinoma. Initially diagnosed in December 2021, the patient underwent successful resection and subsequent adjuvant therapy. Despite stable disease following chemotherapy augmented with durvalumab, he developed grade 3 acute hepatitis after seven cycles of durvalumab. Following a brief prednisolone regimen and normalization of liver tests, SBRT targeting para-aortic lymph nodes was initiated. Remarkably, severe hepatitis reoccurred 7 days after starting SBRT, 88 days following the last durvalumab infusion, necessitating resumed and escalated prednisolone treatment. Another course of SBRT for a newly diagnosed metastatic liver lesion was administered in September 2023, with ongoing prednisolone adjustment. By February 2024, liver tests normalized, but subsequent radiological assessments indicated tumor progression, leading to the reintroduction of chemotherapy. This case underscores the potential of SBRT for activating severe immune-mediated hepatotoxicity in patients treated with ICIs, highlighting the need for careful monitoring and management of such patients. Further, this report highlights the possible survival benefit of the strategic application of SBRT in addition to systematic treatment in recurrent and metastatic cholangiocellular carcinoma.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189606","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":"Automated contouring for breast cancer radiotherapy in the isocentric lateral decubitus position: a neural network-based solution for enhanced precision and efficiency.","authors":"Pierre Loap, Rémi Monteil, Youlia Kirova, Jérémi Vu-Bezin","doi":"10.1007/s00066-024-02364-x","DOIUrl":"https://doi.org/10.1007/s00066-024-02364-x","url":null,"abstract":"<p><strong>Background: </strong>Adjuvant radiotherapy is essential for reducing local recurrence and improving survival in breast cancer patients, but it carries a risk of ischemic cardiac toxicity, which increases with heart exposure. The isocentric lateral decubitus position, where the breast rests flat on a support, reduces heart exposure and leads to delivery of a more uniform dose. This position is particularly beneficial for patients with unique anatomies, such as those with pectus excavatum or larger breast sizes. While artificial intelligence (AI) algorithms for autocontouring have shown promise, they have not been tailored to this specific position. This study aimed to develop and evaluate a neural network-based autocontouring algorithm for patients treated in the isocentric lateral decubitus position.</p><p><strong>Materials and methods: </strong>In this single-center study, 1189 breast cancer patients treated after breast-conserving surgery were included. Their simulation CT scans (1209 scans) were used to train and validate a neural network-based autocontouring algorithm (nnU-Net). Of these, 1087 scans were used for training, and 122 scans were reserved for validation. The algorithm's performance was assessed using the Dice similarity coefficient (DSC) to compare the automatically delineated volumes with manual contours. A clinical evaluation of the algorithm was performed on 30 additional patients, with contours rated by two expert radiation oncologists.</p><p><strong>Results: </strong>The neural network-based algorithm achieved a segmentation time of approximately 4 min, compared to 20 min for manual segmentation. The DSC values for the validation cohort were 0.88 for the treated breast, 0.90 for the heart, 0.98 for the right lung, and 0.97 for the left lung. In the clinical evaluation, 90% of the automatically contoured breast volumes were rated as acceptable without corrections, while the remaining 10% required minor adjustments. All lung contours were accepted without corrections, and heart contours were rated as acceptable in 93.3% of cases, with minor corrections needed in 6.6% of cases.</p><p><strong>Conclusion: </strong>This neural network-based autocontouring algorithm offers a practical, time-saving solution for breast cancer radiotherapy planning in the isocentric lateral decubitus position. Its strong geometric performance, clinical acceptability, and significant time efficiency make it a valuable tool for modern radiotherapy practices, particularly in high-volume centers.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123701","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}