Strahlentherapie und Onkologie最新文献

{"title":"Impact of dose volume parameters and clinical characteristics on radiation-induced acute oral mucositis for head and neck cancer patients treated with carbon-ion radiotherapy dose volume outcome analysis.","authors":"Yujiao Li, Xiyin Guan, Chaosu Hu","doi":"10.1007/s00066-024-02255-1","DOIUrl":"10.1007/s00066-024-02255-1","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the predictive value of different dosimetric parameters for acute radiation oral mucositis (ROM) in head and neck cancer (HNCs) patients treated with carbon-ion radiotherapy (CIRT).</p><p><strong>Methods: </strong>44 patients with HNCs treated with CIRT were evaluated for acute ROM which was defined as severe when the score ≥3 (acute ROM was scored prospectively using the Radiation Therapy Oncology Group (RTOG) score system). Predictive dosimetric factors were identified by using univariate and multivariate analysis.</p><p><strong>Results: </strong>Male gender, weight loss >5%, and total dose/fractions were related factors to severe ROM. In multivariate analysis, grade ≥3 ROM was significantly related to the Dmax, D10, D15, and D20 (P < 0.05, respectively). As the receiver operating characteristics (ROC) curve shows, the area under the curve (AUC) for D10 was 0.77 (p = 0.003), and the cutoff value was 51.06 Gy (RBE); The AUC for D15 was 0.75 (p = 0.006), and the cutoff value was 42.82 Gy (RBE); The AUC for D20 was 0.74 (p = 0.009), and the cutoff value was 30.45 Gy (RBE); The AUC for Dmax was 0.81 (p < 0.001), and the cutoff value was 69.33 Gy (RBE).</p><p><strong>Conclusion: </strong>Male gender, weight loss, and total dose/fractions were significantly association with ROM. Dmax, D10, D15 and D20 were identified as the most valuable predictor and we suggest a Dmax limit of 69.33 Gy (RBE), D10 limit of 51.06 Gy (RBE), D15 limit of 42.82 Gy (RBE), and D20 limit of 30.45 Gy (RBE) and for oral mucosa.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"895-902"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459460","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 radiotherapy alone compared with intensity-modulated radiotherapy plus concurrent chemotherapy in intermediate-risk nasopharyngeal carcinoma : A prospective multicenter phase II trial.","authors":"Shufang Liao, Bin Zhang, Yixin Su, Yufei Pan, Jian Zhang, Zhenkai Ye, Rongjun Zhang, Xiangyun Kong, Guanjie Qin, Yunyan Mo, Xiaolan Ruan, Jian Liu, Chunqiao Gan, Jinxuan Dai, Ruyun Zhang, Guanhong Luo, Xiaofei Liao, Wei Jiang","doi":"10.1007/s00066-024-02201-1","DOIUrl":"10.1007/s00066-024-02201-1","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the clinical benefit of adding concurrent chemotherapy to intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) patients with an intermediate risk (stage II and T3N0M0).</p><p><strong>Methods: </strong>A multicenter phase II randomized trial was conducted in intermediate-risk NPC patients. Enrolled patients were previously untreated and aged ranged from 18 to 70 years without severe coexisting diseases. Patients were randomly assigned to receive IMRT alone or IMRT+concurrent chemotherapy (CC; three cycles of 80 mg/m² cisplatin every 3 weeks). Primary endpoint was defined as 3‑year progression-free survival (PFS). The secondary endpoints were distant metastasis-free survival (DMFS), locoregional relapse-free survival (LRRFS), overall survival (OS), and treatment-associated toxicity. We registered this study with Chinese Clinical Trial Registry (CliCTR1800017132; registered July 13, 2018, study start July 13, 2018).</p><p><strong>Results: </strong>From November 2015 to July 2019, 42 patients with stage II and T3N0M0 NPC were enrolled; 20 patients received IMRT alone while 22 patients received IMRT+CC. After a median of 58 months of follow-up, we estimated the 3‑year PFS rates as 90% (IMRT group) and 86.4% (IMRT+CC group; hazard ratio 1.387, 95% confidence interval 0.240-8.014; P = 0.719). The 3‑year PFS, OS, and cumulative DMFS and LRRFS showed no significant differences between the two groups (P > 0.05). However, the IMRT group displayed a lower incidence of nausea/vomiting, leucopenia, and dry mouth than the IMRT+CC group.</p><p><strong>Conclusion: </strong>Adding CC to IMRT provided no survival benefit but increased treatment-associated toxicities in patients with intermediate-risk NPC.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"867-875"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698342","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":"Clinical and MRI risk factors predicting post-irradiation carotid blowout syndrome in patients with nasopharyngeal cancer.","authors":"Ang Yang, Fei Duan, Ruo Lan Zao, Xue Hong Xiao, Ze Yan Wang","doi":"10.1007/s00066-024-02247-1","DOIUrl":"10.1007/s00066-024-02247-1","url":null,"abstract":"<p><strong>Objective: </strong>To explore the clinical and imaging features of nasopharyngeal cancer (NPC) complicated by acute carotid blowout syndrome (CBS), analyze the risk factors for CBS, and improve diagnostic vigilance for early intervention.</p><p><strong>Methods: </strong>This retrospective review was conducted between January 2003 and May 2023. Altogether, 49 patients with post-irradiation NPC with CBS and 49 patients without CBS as control group were enrolled. The condition of the patients when CBS occurred was reviewed. Patient characteristics of the CBS and control groups were compared, and binary logistic regression analysis was performed to identify risk factors for CBS.</p><p><strong>Results: </strong>All patients in the CBS group were conscious, and 41 patients had a Karnofsky performance assessment scale score of ≥ 70. After interventional therapy, 43 patients survived (the mean survival time of patients after CBS was 3.2 ± 2.1 years). Compared with the control group, the CBS group had a higher incidence of sphenoid sinusitis (81% vs. 52.4%), osteonecrosis (82.9% vs. 51.2%), artery exposure (29.3% vs. 4.9%), and internal carotid artery injury (61% vs. 29.3%). Osteonecrosis and artery exposure were selected as important risk factor for CBS, with p-values of 0.016 and 0.031, respectively.</p><p><strong>Conclusion: </strong>CBS is an important factor that affects the survival of patients with NPC. If internal carotid artery injury, artery exposure, sphenoid sinusitis, and osteonecrosis are present, especially the latter two signs, the possibility of CBS should be considered.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"876-881"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311795","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":"[Targeted therapy in EGFR-mutated lung cancer following chemoradiotherapy].","authors":"Jörg Andreas Müller, Dirk Vordermark","doi":"10.1007/s00066-024-02284-w","DOIUrl":"10.1007/s00066-024-02284-w","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"921-923"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879489","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 34-gene expression biomarker to predict oncologic outcome and treatment response after radiotherapy in meningioma].","authors":"Maximilian Y Deng, Felix Sahm, Jürgen Debus, Laila König","doi":"10.1007/s00066-024-02268-w","DOIUrl":"10.1007/s00066-024-02268-w","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"916-918"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731419","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":"Friedrich Dessauer (1881-1963): the forgotten medical physicist, politician, and philosopher.","authors":"David Benzaquen, Daniel Taussky, Pierre-Alain Tercier, Ambroise Champion","doi":"10.1007/s00066-024-02252-4","DOIUrl":"10.1007/s00066-024-02252-4","url":null,"abstract":"<p><p>Today, the name Friedrich Dessauer is almost forgotten; however, his scientific, social, and political works should not be. Dessauer's professional career began at a young age as a professor of physics in Frankfurt am Main. It is said that he published 400 papers and 65 book chapters and pamphlets. He was a technical inventor who established laws that dealt with theories to explain the limited understanding of the effects of radiation on cells. He advocated for methods to improve the therapeutic ratio. As a devout Catholic politician, Dessauer was an early opponent of National Socialism. This led to him being thrown into prison for political reasons in 1933. He did not leave until 1934, and then for Istanbul, largely thanks to Turkish efforts and his appointment as director of a large new institution. While he was already a well-known physicist in Germany, he had to start from scratch in order to build a modern institute. A recent article in the journal Radiotherapy and Oncology celebrated his important contributions to radiology from Turkey. After his contract in Istanbul expired in 1937, he left for the small University of Fribourg in Switzerland, where he was unfortunately unable to continue his scientific productivity. Dessauer wrote textbooks as well as political and philosophical books, and attempted to bridge the gap between Catholicism and science. Additionally, after the war, he began to teach again in Frankfurt. In photos of Dessauer, radiation-induced skin changes on his face and hands were clearly visible. Towards the end of his life, he received many medals and honors for his achievements in Germany, some of them posthumously.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"853-856"},"PeriodicalIF":2.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459459","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":"Early and repetitive novel-tracer PET-guided stereotactic body radiotherapy for nodal oligorecurrent prostate cancer after definitive first-line therapy.","authors":"Arne Grün, Selin Cumaoglu, Anne Kluge, Thorsten Schlomm, Dirk Böhmer, Kurt Miller, Holger Heidenreich, Daniel Zips, Goda Kalinauskaite","doi":"10.1007/s00066-024-02304-9","DOIUrl":"https://doi.org/10.1007/s00066-024-02304-9","url":null,"abstract":"<p><strong>Background: </strong>Prostate-specific membrane antigen (PSMA) positron-emission tomography (PET) imaging can detect prostate cancer (PCa) nodal oligorecurrences (NOR) at very low prostate-specific antigen (PSA) levels. Prospective studies on oligorecurrent (OR) PCa have been hampered by either dated diagnostics or inhomogeneous cohorts and/or treatment approaches. We hypothesized that early and-if necessary and feasible-repetitive PSMA-PET-based metastasis-directed therapy (MDT) using stereotactic body radiotherapy (SBRT) would improve freedom from palliative (systemic) therapy at low toxicity.</p><p><strong>Methods: </strong>This study is a retrospective analysis of patients treated for OR PCa after definitive first-line therapy using PSMA-PET/CT-based SBRT. Endpoints were biochemical progression-free survival (bPFS), SBRT-free survival (SBRT-FS), androgen deprivation therapy (ADT)-free survival (ADT-FS), and toxicity.</p><p><strong>Results: </strong>A total of 67 patients and 248 metastases (211 nodal) were treated. Patients on concurrent ADT were excluded. Median PSA at inclusion was 2.175 ng/ml. bPFS, SBRT-FS, and ADT-FS for multiple-course SBRT were 9.5, 19.5, and 35.0 months, respectively; 32 patients had ≥ 1 course of SBRT. Median PSA nadir was 0.585 ng/ml. There was no ≥ grade 2 toxicity.</p><p><strong>Conclusion: </strong>Modern-tracer PET/CT-based early and repetitive focal SBRT yields promising results with regard to bPFS, SBRT-FS, and ADT-FS with low toxicity. The ability of this approach to postpone initiation of palliative treatment with low toxicity should be re-evaluated prospectively.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354138","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":"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":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-27","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":"Irradiation alters extracellular vesicle microRNA load in the serum of patients with leukaemia.","authors":"Stephanie Hehlgans, Denise Eckert, Daniel Martin, Katalin Lumniczky, Gesine Bug, Claus Rödel, Franz Rödel","doi":"10.1007/s00066-024-02307-6","DOIUrl":"https://doi.org/10.1007/s00066-024-02307-6","url":null,"abstract":"<p><strong>Purpose: </strong>Recent data suggest an impact of extracellular vesicles (EVs) and their micro(mi)RNA cargo on cell-cell interactions to contribute to pathophysiology of leukaemia and radiation response. Here, we investigated differential miRNA cargo of EVs from serum derived from patients with leukaemia (n = 11) before and after total body irradiation with 2 × 2 Gy as compared to healthy donors (n = 6).</p><p><strong>Methods: </strong>RNA was isolated from EVs and subjected to next generation sequencing of miRNAs. Analysis of sequencing data was performed with miRDeep29 software and differentially expressed miRNAs were filtered using R package edgeR10,11. Signaling pathways were identified using Kyoto Encyclopedia of Genes and Genomes database (KEGG) pathway analysis.</p><p><strong>Results: </strong>Flow cytometric and Western blot analyses confirmed the presence of characteristic EV markers TSG-101, CD‑9 and CD-81. miRNA sequencing revealed a differential cargo in serum of patients with leukaemia in comparison to healthy donors with 23 significantly upregulated and 16 downregulated miRNAs affecting hedgehog, estrogen, glutathione metabolism and peroxisome proliferator-activated receptor (PPAR) signaling pathways amongst others. Whole body irradiation of patients with leukaemia significantly increased 11 miRNAs, involved in cell cycle regulation and platinum drug resistance, and decreased 15 miRNAs, contributing to apoptosis or cytokine-receptor interactions.</p><p><strong>Conclusion: </strong>As compared to healthy controls and following irradiation, we have identified differentially regulated miRNAs in serum-derived EVs from patients with leukaemia that may serve as possible biomarkers of leukaemic disease and treatment and radiation exposure.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354139","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":"Sustainability in radiation oncology: opportunities for enhancing patient care and reducing CO₂ emissions in breast cancer radiotherapy at selected German centers.","authors":"Ahmed Bedir, Maximilian Grohmann, Sebastian Schäfer, Matthias Mäurer, Steffen Weimann, Julian Roers, Dominik Hering, Michael Oertel, Daniel Medenwald, Christoph Straube","doi":"10.1007/s00066-024-02303-w","DOIUrl":"https://doi.org/10.1007/s00066-024-02303-w","url":null,"abstract":"<p><strong>Background and objective: </strong>Radiotherapy often entails a substantial travel burden for patients accessing radiation oncology centers. The total travel distance for such treatments is primarily influenced by two factors: fractionation schedules and the distances traveled. Specific data on these aspects are not well documented in Germany. This study aims to quantify the travel distances for routine breast cancer patients of five radiation oncology centers located in metropolitan, urban, and rural areas of Germany and to record the CO₂ emissions resulting from travel.</p><p><strong>Methods: </strong>We analyzed the geographic data of breast cancer patients attending their radiotherapy treatments and calculated travelling distances using Google Maps. Carbon dioxide emissions were estimated assuming a standard 40-miles-per-gallon petrol car emitting 0.168 kg of CO₂ per kilometer.</p><p><strong>Result: </strong>Addresses of 4198 breast cancer patients treated between 2018 and 2022 were analyzed. Our sample traveled an average of 37.2 km (minimum average: 14.2 km, maximum average: 58.3 km) for each radiation fraction. This yielded an estimated total of 6.2 kg of CO₂ emissions per visit, resulting in 156.2 kg of CO₂ emissions when assuming 25 visits (planning, treatment, and follow-up).</p><p><strong>Conclusion: </strong>Our study highlights the environmental consequences associated with patient commutes for external-beam radiotherapy, indicating that reducing the number of treatment fractions can notably decrease CO₂ emissions. Despite certain assumptions such as the mode of transport and possible inaccuracies in patient addresses, optimizing fractionation schedules not only reduces travel requirements but also achieves greater CO₂ reductions while keeping improved patient outcomes as the main focus.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354173","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}