Strahlentherapie und Onkologie最新文献

{"title":"Carbon ion radiotherapy optimization techniques for pancreatic cancer: accounting for the effect of bowel gas variation.","authors":"Chaebeom Sheen, Sunghyun Lee, Bitbyeol Kim, Jaeman Son, Kyungsu Kim, Hyeongmin Jin","doi":"10.1007/s00066-025-02450-8","DOIUrl":"https://doi.org/10.1007/s00066-025-02450-8","url":null,"abstract":"<p><strong>Background: </strong>Dose variation due to changes in bowel air poses significant challenges for carbon radiotherapy in pancreatic cancer. This retrospective study evaluated a density-override optimization technique to mitigate dosimetric uncertainties caused by bowel air changes.</p><p><strong>Materials and methods: </strong>Planning CT and cone-beam CT data from 8 patients with locally advanced pancreatic cancer undergoing stereotactic ablative radiotherapy were analyzed. Treatment simulations used a dose of 55.2 GyE in 12 fractions with a four-field setup (anterior, lateral, posterior, posterior oblique). Four density-override patterns were compared: pattern 0 (no override), pattern 1 (replacing bowel gas with water), pattern 2 (replacing the entire bowel with mean bowel HU), and pattern 3 (replacing bowel gas with mean bowel HU). Dose evaluations included fraction-wise and accumulated dose analyses, focusing on target coverage, homogeneity index, and organs at risk doses.</p><p><strong>Results: </strong>Pattern 2 achieved the largest clinical tumor volume coverage and the fewest fractions with > 5% coverage loss for the anterior beam, followed by pattern 3. However, pattern 2 demonstrated poorer homogeneity for the lateral beam compared to patterns 1 and 3 and a higher gastrointestinal (GI) dose for the anterior beam.</p><p><strong>Conclusion: </strong>This study evaluated the importance of density overrides to address bowel air variations. For patients where a more uniform dose is desirable or whose tumor is adjacent to the GI tract, a pattern 3 density-override should be considered.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969573","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 prognostic role of the ¹⁸F-FDG PET/CT metabolic response in locally advanced cervical cancer after definitive chemoradiotherapy: a narrative review.","authors":"Lorena Draghini, Sara Costantini, Edy Ippolito, Francesca De Felice, Angela Caroli, Federico Navarria, Federica Piccolo, Bruno Fionda, Vitaliana De Sanctis, Gabriella Macchia, Lisa Vicenzi","doi":"10.1007/s00066-025-02452-6","DOIUrl":"10.1007/s00066-025-02452-6","url":null,"abstract":"<p><strong>Purpose: </strong>In locally advanced cervical cancer (LACC), chemoradiotherapy (CRT) represents the standard of care. The aim of this narrative review is to investigate the prognostic role of metabolic response of ¹⁸F-FDG PET-CT after CRT in LACC patients.</p><p><strong>Methods: </strong>We reviewed the literature according to the PRISMA guidelines to identify studies up to December 2023. The literature search was performed on PubMed and Scopus, using the following combination of medical subject headings (MeSH) and keywords \"Uterine Cervical Neoplasms\", \"¹⁸F-FDG PET-CT\", \"locally advanced cervical cancer\", \"chemoradiotherapy\". Studies assessing metabolic response after CRT in LACC were included. All abstracts and full-text articles were screened independently by four authors. Discrepancies were resolved through discussion with a third party.</p><p><strong>Results: </strong>After the literature research, 9 studies fulfilled the inclusion criteria and were included in this review. Metabolic response after radical CRT treatment was significantly related to better clinical outcomes and to lower local relapse. Incomplete metabolic response could be considered a predictive factor for distant metastasis and cancer related deaths.</p><p><strong>Conclusion: </strong>Current data highlight the potential role of metabolic response of ¹⁸F-FDG PET-CT after CRT to predict survival outcomes. LACC patients are likely to benefit from this imaging technique in the follow up management. Patients with incomplete metabolic response could be addressed to further additional therapeutic strategies.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875245","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":"Impact of pretreatment PET/MRI on radiooncologic target delineation in Hodgkin's lymphoma: a case series.","authors":"Kai Kröger, Sebastian Lohmann, Michael Oertel, Peter Borchmann, Andrea Kerkhoff, Georg Lenz, Lars Stegger, Hans Theodor Eich","doi":"10.1007/s00066-025-02446-4","DOIUrl":"https://doi.org/10.1007/s00066-025-02446-4","url":null,"abstract":"<p><strong>Purpose: </strong>Positron-emission tomography combined with computed tomography (PET/CT) is the diagnostic standard for patients with Hodgkin's lymphoma. Positron-emission tomography combined with magnetic resonance imaging (PET/MRI) is an alternative diagnostic modality that reduces radiation exposure to the patient. This study aims to evaluate the potential merits of PET/MRI compared to PET/CT for target delineation for radiotherapy of Hodgkin's lymphoma.</p><p><strong>Methods: </strong>Five patients with newly diagnosed Hodgkin's lymphoma underwent PET/CT imaging directly followed by PET/MRI imaging as part of initial staging. Both modalities were subsequently compared regarding each patient's diagnosed involved nodal regions. Three of these patients received radiotherapy after the completion of chemotherapy. In the radiotherapy planning CT, different gross tumor volumes and clinical target volumes were contoured for both PET/CT and PET/MRI and quantitatively compared using the Dice coefficient.</p><p><strong>Results: </strong>No differences regarding the diagnosed disease stage were observed. The delineated tumor and target volumes showed minor differences without clinical significance.</p><p><strong>Conclusion: </strong>Positron-emission tomography/MRI is a viable option to assure adequate staging and later target delineation in patients with Hodgkin's lymphoma. Due to the reduction of radiation exposure compared to PET/CT, it might be the preferable option if readily available.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856360","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":"Efficient workflow and clinical validation of in-house 3D-printed vaginal cylinders for high-dose-rate brachytherapy for gynecologic malignancies.","authors":"Shinya Komori, Yoshiaki Takagawa, Akihiko Takeuchi, Hiroki Sato, Takahiro Kato","doi":"10.1007/s00066-025-02451-7","DOIUrl":"https://doi.org/10.1007/s00066-025-02451-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study developed an efficient methodology for in-house 3D-printed vaginal cylinders for gynecologic tumor treatment by evaluating their radiation attenuation, geometric accuracy, and efficacy. Ultimately, we aim to establish a simple, cost-effective approach that facilitates broad clinical adoption.</p><p><strong>Methods: </strong>Patient-specific vaginal cylinders were designed based on anatomical contours from the treatment planning system (TPS) using CAD software. The process was optimized to minimize manpower and time costs. Radiation attenuation of the 3D printer material was compared with that of water using the Monte Carlo method. Geometric accuracy was automatically analyzed via an in-house MATLAB program. Efficacy was assessed in cases of postoperative vaginal stump recurrence and vaginal cancer with paravaginal invasion.</p><p><strong>Results: </strong>The tumor shape, delineated by TPS, was imported into CAD software, and the catheter pathway model, designed via subtraction processing, was placed at the optimal position and angle. The design process took approximately 15 min, and the entire workflow was completed within a week, demonstrating its practicality for clinical use. The radiation attenuation error was < 3% compared with water, and the geometric accuracy error was < 0.2 mm. The patient-specific vaginal cylinder provided a favorable dose distribution and was effective in complex cases.</p><p><strong>Conclusion: </strong>A feasible workflow was established, allowing in-house design and manufacturing with reduced manpower and time costs. With no material or processing issues, this approach is safe, practical, and promising for widespread adoption in personalized brachytherapy.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy in the treatment of malignant fungating wounds: clinical practice, response rates, and outcome from a tertiary cancer center.","authors":"Anna Lena Reinking, Martin Leu, Leif Hendrik Dröge, Benedikt Kieslich, Sandra Donath, Markus Anton Schirmer, Stephanie Bendrich, Laura Anna Fischer, David Alexander Ziegler, Hannes Treiber, Enver Aydilek, Raphael Koch, Stefan Rieken, Manuel Guhlich","doi":"10.1007/s00066-025-02443-7","DOIUrl":"https://doi.org/10.1007/s00066-025-02443-7","url":null,"abstract":"<p><strong>Purpose: </strong>Malignant fungating wounds (MFW) are a distressing condition caused by aggressive tumor growth infiltrating the skin. Regularly causing pain, exudation, bleeding, edema and odor, they negatively affect the patients' quality of life (QoL). Radiotherapy (RT) can reduce MFW-associated symptoms and is routinely used in clinical settings, both in curative as well as palliative treatment regimes. However, fundamental data on treatment response, symptom relief and oncological outcomes, as well as potential confounders of treatment response are currently limited.</p><p><strong>Methods: </strong>We performed a retrospective analysis of patients with MFW who received RT between 01/2000 and 06/2022 at our tertiary cancer center. Achievement of treatment goals, including reduction of pain and tumor mass, cessation of bleeding, and improvement of wound condition, were evaluated. The effect of variables on the achievement of treatment goals were assessed by logistic regression. The effect of parameters on overall survival (OS) were assessed using the Kaplan-Meier plot with log-rank test and Cox regression analysis. Statistically significant (p-value < 0.05) confounders were tested in multivariable analyses.</p><p><strong>Results: </strong>101 patients were included. 69.3% of treatments were in palliative intent, 30.7% in curative intent. Main tumor entities were breast cancer, squamous cell carcinoma of the skin and vulvar carcinoma, accounting for 26.7, 22.8 and 9.9% of patients. Main treated locations were head & neck (38.6%), breast/chest wall (29.7%) and genitals (9.9%). Main treated areas were primary tumor (52.5%) and metastasis (22.8%). Concurrent systemic therapy was administered in 32.7%. The predefined therapy goal was achieved in 85% of patients. Median overall survival was 7.8 months. Concurrent systemic therapy was statistically significant associated with achieving the therapy goal [logistic regression; HR 8.45 (95% CI: 1.06-67.37, p = 0.04)]. Concurrent systemic therapy, lower CCI and achieving the therapy related goal were significantly associated with higher overall survival. Overall toxicity was low.</p><p><strong>Conclusion: </strong>RT for MFW is a highly effective treatment option, resulting in very high local tumor regression rates. It therefore reduces the numerous negative QoL-affecting consequences for the patients, which often present in a palliative state. Concurrent systemic therapy can be a prognostically relevant treatment option.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822658","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":"Non-invasive prediction of the secondary enucleation risk in uveal melanoma based on pretreatment CT and MRI prior to stereotactic radiotherapy.","authors":"Yagiz Yedekci, Hidetaka Arimura, Yu Jin, Melek Tugce Yilmaz, Takumi Kodama, Gokhan Ozyigit, Gozde Yazici","doi":"10.1007/s00066-025-02449-1","DOIUrl":"https://doi.org/10.1007/s00066-025-02449-1","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to develop a radiomic model to non-invasively predict the risk of secondary enucleation (SE) in patients with uveal melanoma (UM) prior to stereotactic radiotherapy using pretreatment computed tomography (CT) and magnetic resonance (MR) images.</p><p><strong>Materials and methods: </strong>This retrospective study encompasses a cohort of 308 patients diagnosed with UM who underwent stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT) using the CyberKnife system (Accuray, Sunnyvale, CA, USA) between 2007 and 2018. Each patient received comprehensive ophthalmologic evaluations, including assessment of visual acuity, anterior segment examination, fundus examination, and ultrasonography. All patients were followed up for a minimum of 5 years. The cohort was composed of 65 patients who underwent SE (SE+) and 243 who did not (SE-). Radiomic features were extracted from pretreatment CT and MR images. To develop a robust predictive model, four different machine learning algorithms were evaluated using these features.</p><p><strong>Results: </strong>The stacking model utilizing CT + MR radiomic features achieved the highest predictive performance, with an area under the curve (AUC) of 0.90, accuracy of 0.86, sensitivity of 0.81, and specificity of 0.90. The feature of robust mean absolute deviation derived from the Laplacian-of-Gaussian-filtered MR images was identified as the most significant predictor, demonstrating a statistically significant difference between SE+ and SE- cases (p = 0.005).</p><p><strong>Conclusion: </strong>Radiomic analysis of pretreatment CT and MR images can non-invasively predict the risk of SE in UM patients undergoing SRS/FSRT. The combined CT + MR radiomic model may inform more personalized therapeutic decisions, thereby reducing unnecessary radiation exposure and potentially improving patient outcomes.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804865","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":"Empiric stereotactic body radiotherapy for presumed early-stage lung cancer : Pulmonary function changes, treatment-related toxicity and survival outcome.","authors":"Esra Degerli, Karim El-Marouk, Lukas Käsmann, Khulangaa Khaltar, Sina Mansoorian, Cedric Richlitzki, Diego Kauffmann-Guerrero, Amanda Tufman, Niels Reinmuth, Thomas Duell, Nina-Sophie Schmidt-Hegemann, Farkhad Manapov, Claus Belka, Chukwuka Eze","doi":"10.1007/s00066-025-02434-8","DOIUrl":"https://doi.org/10.1007/s00066-025-02434-8","url":null,"abstract":"<p><strong>Background: </strong>Due to demographic shifts, the population is aging, and patients are experiencing more comorbidities. Stereotactic body radiotherapy (SBRT) offers high rates of local control for patients with medically inoperable early-stage non-small cell lung cancer (NSCLC). However, obtaining histopathological confirmation can be challenging due to severe comorbidities, small tumors, or unfavorable anatomical locations.</p><p><strong>Methods: </strong>Between 2011 and 2022, we retrospectively analyzed a cohort of patients who underwent lung SBRT for presumed early-stage NSCLC at our institution. Out of 486 consecutive patients treated during this period, 56 patients (11.5%) with a total of 61 lesions were identified and included in this retrospective study. All included patients lacked histopathological confirmation prior to treatment and had no evidence of other active malignancies. The primary objective of this analysis was to evaluate pulmonary function tests before and after SBRT, including long-term follow-up.</p><p><strong>Results: </strong>The median overall survival (OS) after empiric SBRT was 50.7 months (95% confidence interval [CI] 12.8-88.7). Survival rates at 1 year and 2 years were 88.4 and 71.1%, respectively. The 1‑, 2‑ and 3‑year local control rates were 96.6%, 92.3% and 87.1%. Pulmonary function tests indicated a relative increase in the mean forced expiratory volume in 1 s (FEV1) of 0.55% (SD 13.5) and 2.0% (SD: 20.0) at 6 and 12 months, respectively. In contrast, the mean diffusing capacity of the lungs for carbon monoxide (DLCO) showed a relative decline of 7.4% (SD 16.6) and 6.3% (SD 26.1) at 6 and 12 months, respectively. Patients with lower comorbidity scores (CCI ≤ 5) exhibited significantly improved OS (p = 0.011). Long-term oxygen therapy (LTOT) prior to SBRT was associated with shorter OS (p = 0.02) and a relatively high incidence of grade 2-3 pulmonary disorders. Chronic obstructive pulmonary disease (COPD) was identified as a possible risk factor for severe treatment-related toxicity. Notably, all patients who experienced grade 3 pulmonary disorders required LTOT before SBRT.</p><p><strong>Conclusion: </strong>Empiric SBRT is a safe and effective treatment for presumed early-stage NSCLC in patients without histopathological confirmation. Even in patients requiring oxygen therapy and with severe comorbidities, long-term survival is feasible with acceptable treatment-related toxicity. Optimal dose fractionation and biologically effective dose (BED) levels for frail patients without histological confirmation remain undefined. Prospective trials are warranted to determine the most effective and safe SBRT regimens for this vulnerable patient population.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785338","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":"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":"818-827"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283462/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toxicity profile and clinical outcomes of stereotactic body radiotherapy with a focal boost without fiducials or perirectal hydrogel spacer for localized prostate cancer.","authors":"Yuichiro Tsurugai, Atsuya Takeda, Naoko Sanuki, Yousuke Aoki, Yuto Kimura, Yohei Oku, Tomohiro Eriguchi, Hiroyuki Yamanaka, Maiko Machida, Tomohiko Matsushita, Shiro Saito","doi":"10.1007/s00066-024-02333-4","DOIUrl":"10.1007/s00066-024-02333-4","url":null,"abstract":"<p><strong>Purpose: </strong>Whole-prostate dose escalation in stereotactic body radiotherapy (SBRT) for localized prostate cancer (PCa) can improve oncological outcomes, albeit at the cost of increased toxicity. A focal boost to the dominant intraprostatic lesion (DIL) is gaining interest as an alternative approach. Herein, we investigate the safety and efficacy of this approach.</p><p><strong>Methods: </strong>This retrospective study enrolled patients with localized PCa who underwent five-fraction SBRT with a focal boost to the DIL at our institution between May 2016 and August 2021. The prescription doses to the whole prostate were 35 and 36.25 Gy for low- to favorable intermediate-risk PCa and unfavorable intermediate- to high-risk PCa, respectively. The focal boost to the DIL was up to 115-140% of the prescribed dose. None of the patients underwent pretreatment fiducial or perirectal hydrogel spacer placement. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities and oncological outcomes were assessed.</p><p><strong>Results: </strong>Among the 520 patients, 44% were categorized as patients with high-risk PCa. The median follow-up period was 42.9 months. No acute or late grade ≥3 toxicities were observed. Acute and late grade 2 GU toxicities were observed in 22.3 and 6.1%, respectively, while GI toxicities were observed in 2.1 and 0.8% of the patients. The 4‑year relapse-free survival rate was 94.8% among all patients.</p><p><strong>Conclusion: </strong>Our results indicate that SBRT with a focal boost without fiducials or perirectal hydrogel spacer for localized PCa has a promising toxicity profile and oncological outcomes. Longer follow-up studies are necessary to adequately evaluate late toxicities and efficacy.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"779-787"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802313","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":"[Screening for prostate cancer with a polygenic risk score].","authors":"Jürgen Dunst","doi":"10.1007/s00066-025-02431-x","DOIUrl":"10.1007/s00066-025-02431-x","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"859-862"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508311","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}