Strahlentherapie und Onkologie最新文献

{"title":"Ceftriaxone has a neuroprotective effect in a whole-brain irradiation-induced neurotoxicity model by increasing GLT-1 and reducing oxidative stress.","authors":"Nilsu Cini, Özüm Atasoy, Yigit Uyanikgil, Gökhan Yaprak, Mümin Alper Erdoğan, Oytun Erbas","doi":"10.1007/s00066-025-02405-z","DOIUrl":"10.1007/s00066-025-02405-z","url":null,"abstract":"<p><strong>Background: </strong>Radiation-induced brain injury is a prominent side effect of whole-brain irradiation (IR) due to triggered oxidative and inflammatory processes, often resulting in severe and debilitating cognitive dysfunction and neuronal damage. The development of persistent oxidative stress results from radiation-induced reactive oxygen species. Another result is the initiation of glutamate excitotoxicity, which is closely associated with changes in glutamate levels. Elevated release or reduced glutamate uptake disrupts neuronal homeostasis, leading to oxidative stress, mitochondrial dysfunction, and neuroinflammation. The neuroprotective and antioxidant properties of ceftriaxone (CTX) have been linked to its ability to reduce glutamate excitotoxicity, inflammation, and to modulate oxidative stress.</p><p><strong>Materials and methods: </strong>Twenty-one female Wistar rats were included in the study, and 14 of them underwent whole-brain IR with a single dose of 20 Gy on day 7. Saline and CTX applications continued for 21 days. The animals were divided into three groups: group 1: normal control; group 2: IR + saline; and group 3: IR + CTX. To compare the groups, a one-way analysis of variance (ANOVA) statistical test was employed, with a significance threshold set at p < 0.05.</p><p><strong>Results: </strong>Ceftriaxone treatment had a positive impact on the results of various assessments, e.g., behavioral tests including the three-chamber sociability test, the open-field test, and passive avoidance learning. It also led to increased counts of hippocampal CA1, CA3, and Purkinje neurons as well as elevated brain levels of brain-derived neurotrophic factor (BDNF), glutamate transporter 1 (GLT-1), and superoxide dismutase (SOD) activity. Conversely, CTX reduced the glial fibrillary acidic protein (GFAP) immunostaining index as well as brain levels of malondialdehyde (MDA) and tumor necrosis factor alpha (TNF-α).</p><p><strong>Conclusion: </strong>Ceftriaxone demonstrated promising effectiveness in mitigating radiation-induced neurocognitive impairments and the deterioration of social memory capacity. This effect is achieved by reducing neuronal loss, oxidative stress, and neuroinflammation in irradiated rat brains. Furthermore, the application of CTX facilitated removal of excess glutamate from synapses, thus preventing glutamate excitotoxicity and protecting neurons from excitotoxic cell death.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"903-919"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038408","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":"CyberKnife radiation therapy for malignant myopericytoma in a pediatric patient: a case report and review of the literature.","authors":"Bence Bukovszky, Júlia Vízkeleti, Levente Jánváry, Gábor Szarvas, Luca Felkai, Rita Bánusz, Edit Varga, Zoltán Sápi, Tibor Major, Monika Csóka","doi":"10.1007/s00066-025-02413-z","DOIUrl":"10.1007/s00066-025-02413-z","url":null,"abstract":"<p><strong>Background: </strong>Malignant myopericytoma is a very rare malignant soft tissue tumor which usually develops during adulthood. It has a very poor prognosis due to its aggressive nature and frequent distant metastases.</p><p><strong>Methods: </strong>In our case report, we present a 17-month-old girl with malignant myopericytoma who was successfully treated using CyberKnife (Accuray; Sunnyvale, CA, USA) stereotactic radiotherapy.</p><p><strong>Results: </strong>A rare localization of the tumor caused significant challenges during the course of treatment. Radical surgical resection was not achievable due to the tumor's location in the inner ear; therefore chemotherapy was initially given to the patient. However, due to the fast progression of the tumor during chemotherapy, we decided to use CyberKnife stereotactic radiosurgery (SRS; 5 fractions of 7 Gy) in order to prevent further invasion of the surrounding tissues. During SRS, tumor growth stopped and the tumor then gradually regressed. Since completion of treatment (currently almost 5 years) our patient has been in complete remission without any significant side effects of the radiation therapy.</p><p><strong>Conclusion: </strong>In our recent experience, systemic chemotherapy combined with CyberKnife SRS proved to be effective in a patient with a rare malignant myopericytoma.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"963-970"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302831","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":"[Less is more: dose de-escalation in early anal cancer-Clinical and functional aspects of quality of life from the PLATO-ACT4 trial].","authors":"L Völler, E Fokas, C Rödel, D Martin","doi":"10.1007/s00066-025-02430-y","DOIUrl":"10.1007/s00066-025-02430-y","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"976-978"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683197","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":"Hyperglycemia is associated with poor survival in patients with brain metastases treated with radiotherapy.","authors":"Soniya Poudyal, Friederike Rothe, Seong Jeong, Nils Gleim, Peter Hambsch, Franziska Nägler, Kirsten Papsdorf, Thomas Kuhnt, Alonso Barrantes-Freer, Erdem Güresir, Sabine Klagges, Nils Henrik Nicolay, Clemens Seidel","doi":"10.1007/s00066-025-02414-y","DOIUrl":"10.1007/s00066-025-02414-y","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes mellitus (DM) is a negative prognostic factor in patients with brain metastases (BM). It is unknown whether a direct impact of serum glucose levels on survival exists. We aimed to detect a potential association of serum glucose levels before and during radiotherapy with survival in patients with BM.</p><p><strong>Methods: </strong>Patients were included in this retrospective exploratory analysis if at least three fasting and non-fasting serum glucose test results before or during treatment were available. Survival was analyzed with uni- and multivariate Cox regression concerning an association with fasting and maximum glucose levels and regarding potentially confounding dexamethasone intake.</p><p><strong>Results: </strong>A total of 62 patients with BM (15 with and 47 without DM) were included. Patients with a mean fasting glucose of more than 7.8 mmol/l (upper quartile) showed significantly shorter survival compared to patients of the lower three quartiles (hazard ratio [HR] = 2.05, p = 0.021). Further, maximum blood glucose levels of > 12.0 mmol/l (upper quartile) were associated with shorter survival (HR = 1.95, p = 0.035). In the subset of patients without DM, a trend toward worse survival in patients with higher fasting glucose levels was observed (HR = 2.54, p = 0.099). The negative association of high maximum glucose levels with survival persisted in multivariate analysis independently of steroid administration.</p><p><strong>Conclusion: </strong>Strong elevations of fasting and maximum serum glucose levels were associated with a worse prognosis in patients with BM with and without DM. This observation warrants further analysis in larger cohorts and has potential implications for clinical practice.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"920-929"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302832","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":"[A scoring system to determine the postoperative recurrence risk after brain metastasis resection].","authors":"Merle Sophie Corvey, Mathias Alexander Sonnhoff, Matthias Sievers","doi":"10.1007/s00066-025-02426-8","DOIUrl":"10.1007/s00066-025-02426-8","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"971-972"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584880","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":"Genomic analysis of radiosensitivity in breast cancer : Identifying pathological determinants and assessing genomic-adjusted radiation dose (GARD) for personalized dose escalation.","authors":"Pierre Loap, Irène Buvat, Alain Fourquet, Youlia Kirova, Gilles Crehange","doi":"10.1007/s00066-025-02454-4","DOIUrl":"https://doi.org/10.1007/s00066-025-02454-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Adjuvant radiotherapy improves recurrence-free survival in breast cancer, but intrinsic tumor radiosensitivity varies substantially, even within histologically similar subtypes. The radiosensitivity index (RSI), based on the expression of 10 genes, and the genomic-adjusted radiation dose (GARD) model enable personalized radiotherapy dosing. This study investigates the association between histological and molecular features and RSI, and quantifies the biological effect of radiation boost doses across conventional and hypofractionated regimens.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Transcriptomic RNA-seq data from 1284 breast cancer patients in The Cancer Genome Atlas Breast Invasive Carcinoma (TCGA-BRCA) cohort were analyzed. RSI was calculated using a rank-based model, and GARD was computed for multiple fractionation schemes, with or without integrated boosts. Univariate and multivariate linear models identified histological and molecular correlates of RSI. EPIC (estimating the proportions of immune and cancer cells) deconvolution was performed to estimate tumor purity and the immune/stromal cell composition. Analyses were restricted to samples with ≥ 50% tumor content. Independent validation was performed in the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) cohort (n = 1981), using microarray-based gene expression data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The median RSI in the TCGA cohort was 0.471 and was significantly lower in basal (p &lt; 0.001) and luminal B (p &lt; 0.001) subtypes, as well as in tumors with necrosis, inflammation, or high mitotic activity. These associations were replicated in the METABRIC validation cohort. Without a boost, 78.6% of the patients in the TCGA cohort would have achieved a GARD &gt; 21 (associated with improved tumor control in retrospective series) with the 50 Gy/25 fractions regimen, compared to 64.8% for 40.05 Gy/15 fractions. The addition of an integrated boost significantly increased GARD values: 95.4% of patients receiving 64.4 Gy/28 fractions and 82.5% receiving 48 Gy/15 fractions achieved a GARD &gt; 21. When stratified by molecular subtype, triple-negative breast cancer (TNBC) subtypes showed the greatest benefit from moderate dose escalation, with over 95% of these patients achieving GARD &gt; 21 with a theoretical 53 Gy boost in 15 fractions. EPIC analysis revealed an inverse correlation between RSI and tumor cell content, and positive associations between RSI and specific immune or stromal components, highlighting the importance of tumor purity in interpreting RSI from bulk RNA data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our results support the biological relevance of RSI and GARD in breast cancer to personalize radiotherapy dose escalation in breast cancer patients and demonstrate their consistency across independent datasets and transcriptomic platforms. Tumor microenvironment composition significantly influences RSI estimation from bulk RNA-seq. Tog","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969745","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":"Long-term clinical results of early-stage lung cancer patients treated with risk-adapted stereotactic body radiotherapy using LINAC or CyberKnife : A single-institution analysis of more than 400 cases.","authors":"Zsolt Levente Jánváry, András Bajcsay, Gábor Stelczer, Gábor Kontra, Tamás Pócza, Mercédesz Gerdán, József Lövey, Zsuzsa S Kocsis, Katalin Ladányi, Éva Pap, Tibor Major, Csaba Polgár","doi":"10.1007/s00066-025-02455-3","DOIUrl":"https://doi.org/10.1007/s00066-025-02455-3","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to evaluate the clinical efficacy and side effects of stereotactic body radiotherapy (SBRT) using a gantry-based linear accelerator (LINAC) or robotic technique in a large cohort of consecutively treated medically inoperable early-stage lung cancer patients.</p><p><strong>Methods: </strong>Between March 2015 and February 2023, 401 early-stage (T1-2 N0 M0) primary lung cancer patients were treated using either LINACs (Varian VitalBeam® and TrueBeam®; Varian, Palo Alto, CA, USA) or CyberKnife® (Accuray, Madison, WI, USA). Median age was 70 years (range 44-90). Diagnosis was based on biopsy for 37.4% of patients, while pathological confirmation was unavailable due to high risk for 62.6%. ¹⁸F‑fluorodeoxyglucose positron-emission tomography (18-FDG-PET) was part of the pretreatment diagnostic workup in 96% (n = 386) of the total cohort. Tumor stage distribution was T1a in 32 (8%), T1b in 179 (44.6%), T1c in 112 (27.9%), T2a in 67 (16.7%), and T2b in 11 (2.7%) patients. Applied dose schemes were identical for both LINAC and CyberKnife treatments, using risk-adapted doses of 45-60 Gy in 3 to 8 fractions, (biologically effective dose ranging from 86 to 151.2 Gy BED₁₀).</p><p><strong>Results: </strong>At a median follow-up of 32 months (range 2-104), the crude survival rate was 58%. Median overall survival (OS) was 63 months (95% CI: 51.1-74.8) the 2‑, 3‑, and 4‑year OS rates were 79, 68, and 56%, respectively. Actuarial local control (LC) rates were 94% at 2 years, 90% at 3 years, and 87% at 4 years. Median LC was not reached. Median local progression-free survival (LPFS) and progression-free survival (PFS) rates were 49.5 months (95% CI: 42.8-56.3) and 37 months (95% CI: 31.2.-42.8), respectively. Actuarial 2‑, 3‑, and 4‑year LPFS and PFS rates were 75, 60, and 51% and 66, 51, and 42%, respectively. On multivariate analysis, BED₁₀ ≥ 132 Gy predicted improved LPFS, while earlier tumor stage and better ECOG performance status were associated with improved OS. No grade 3 or higher acute side effects were observed. Grade 3 late side effects occurred in 4 patients (1%), including grade 3 late pulmonary fibrosis in 3 cases and potentially treatment-related grade 3 pneumothorax in 1 patient. Rib fracture was observed in 14 cases (3%).</p><p><strong>Conclusion: </strong>Clinical results after SBRT at a national comprehensive cancer center demonstrate high LC and LPFS rates and favorable PFS and OS, comparable to published studies. Application of a BED₁₀ of 132 Gy or higher shows a potential benefit in terms of LPFS and may thus be recommended in the absence of conflict with organ at risk constraints. SBRT with either LINAC or CK is proven to be a well-tolerated but still highly effective treatment for the elderly, medically inoperable early-stage lung cancer population.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969718","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":"Correction to: Full bladder, empty rectum? Revisiting a paradigm in the era of adaptive radiotherapy.","authors":"Hanna Malygina, Hendrik Auerbach, Frank Nuesken, Jan Palm, Markus Hecht, Yvonne Dzierma","doi":"10.1007/s00066-025-02459-z","DOIUrl":"https://doi.org/10.1007/s00066-025-02459-z","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969702","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 for treatment of soft tissue sarcomas of the extremities: results of the one arm phase 2 IMRiS study].","authors":"Siyer Roohani, Falk Röder","doi":"10.1007/s00066-025-02456-2","DOIUrl":"https://doi.org/10.1007/s00066-025-02456-2","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969568","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":"Travel distance and potential disparities in palliative radiotherapy access for cancer patients in Victoria, Australia.","authors":"Maike Trommer, Piers Gillett, Fanny Franchini, Karen Trapani, Colin Hornby, Skye Abraham, Dishan Herath, Karla Gough, Keith Donohoe, Phillip Tran, Farshad Foroudi, Maarten IJzerman, Richard Khor","doi":"10.1007/s00066-025-02418-8","DOIUrl":"https://doi.org/10.1007/s00066-025-02418-8","url":null,"abstract":"<p><strong>Background: </strong>Palliative radiotherapy (PRT) is crucial for improving quality of life in patients with advanced-staged cancer. This large data analysis investigates the travel distances and potential disparities in PRT access especially focusing on the burden of excess travel for palliative cancer patients in Victoria, Australia.</p><p><strong>Methods: </strong>Using a state-wide linked dataset from the PRedicting the health economic IMPact of new and current Cancer Treatments (PRIMCAT) research program, we analysed the estimated road travel distance (ERTD) and potential excess travel distance (PETD) as well as received radiotherapy fractions for 29,807 PRT patients being treated from 2010-2019. We examined disparities by socioeconomic status (SEIFA) and remoteness (RA) of the residential area of PRT patients, and receiving treatment at a public or private centre.</p><p><strong>Results: </strong>The average one-way ERTD for all PRT patients was 43 km, with variations based on SEIFA and RA. Patients in the lowest SEIFA quintile and those living in outer regional areas had the longest ERTD. Approximately 50% did not receive treatment at the closest facility, with a mean PETD of 27.9 km for private and 24.3 km for public facility patients. Fractionation patterns showed no significant reduction in the number of fractions with increased travel distance. Patients at private facilities received more fractions on average (8.49) compared to those at public facilities (5.91).</p><p><strong>Conclusion: </strong>This study highlights potential disparities in PRT access in Victoria, with patients living in socioeconomically disadvantaged and remote regions facing longer travel distances and excess travel. These findings underscore the need for strategic referral practices and further research to optimise equitable access to PRT.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969734","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}