Strahlentherapie und Onkologie最新文献

{"title":"Myxoid liposarcoma: treatment outcomes, metastatic pattern and volumetric analysis.","authors":"Vlatko Potkrajcic, Merle Zschiegner, Maximilian Niyazi, Verena Warm, Johannes Tobias Thiel, Sandra Frantz, Christoph K W Deinzer, Franziska Szelat, Elgin Hoffmann, Frank Paulsen, Franziska Eckert","doi":"10.1007/s00066-025-02366-3","DOIUrl":"https://doi.org/10.1007/s00066-025-02366-3","url":null,"abstract":"<p><strong>Background: </strong>Myxoid liposarcoma (MLPS) is a rare subtype of soft tissue sarcoma. This entity has a specific clinical behavior, characterized with a distinct pattern of hematogenous spread, as well as with a unique radiosensitivity and chemosensitivity. Oncologic results, metastatic patterns and treatment response after multimodal therapy were evaluated in a unicentric patient cohort.</p><p><strong>Methods: </strong>Patients with myxoid liposarcoma were retrospectively analyzed in a single institution analysis (n = 31). Oncologic outcomes were evaluated in 28 patients with localized MLPS treated with multimodal therapy in curative intent. Metastatic pattern was analyzed in additional 3 patients with initially metastatic disease. In patients treated with concomitant MR-guided hyperthermia in the preoperative setting (n = 7), tumor size response was evaluated longitudinally during radio(-chemo)therapy in thermometry MRIs and before surgery (based on preoperative imaging).</p><p><strong>Results: </strong>The median follow-up was 4.1 ± 1.0 years. The most common anatomic localization was the lower extremity (78.6%). The 5‑year rates for oncologic outcomes in 28 patients treated in curative intent were 91.7% (± 8.0%) for overall survival (OS), 77.4% (± 11.0%) for local control (LC), 60.1% (± 10.6%) for distant metastasis-free survival (DMFS) and 55.4% (± 11.1%) for disease free survival (DFS). Excellent 5‑year LC (94.7 ± 5.1%) was demonstrated for the cohort excluding 5 patients treated for local recurrences. Most patients had good pathologic response (< 10% vital tumor tissue) following neoadjuvant treatment (82.4%, 14/17). However, this did not correlate with oncologic outcomes. A specific pattern of distant metastases has been observed, with predilection for soft tissues as the most common metastatic site. Furthermore, no isolated pulmonary metastases were observed. The MR analysis demonstrated a significant tumor size reduction (≥ 25%) of the initial tumor volume in 85.7% (n = 6/7) patients. No local recurrences and no distant metastases were observed in patients with significant MR size reduction.</p><p><strong>Conclusion: </strong>Sequential MRIs during preoperative radiotherapy of myxoid liposarcoma show distinct patterns of the known size reduction of this specific subentity. Our analysis of metastatic patterns demonstrate mostly soft tissue metastases, no patient experienced isolated pulmonary metastases.</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":"143123704","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":"Validation of the implementation of phased-array heating systems in Plan2Heat.","authors":"H P Kok, J Crezee","doi":"10.1007/s00066-024-02264-0","DOIUrl":"10.1007/s00066-024-02264-0","url":null,"abstract":"<p><strong>Background: </strong>Hyperthermia treatment planning can be supportive to ensure treatment quality, provided reliable prediction of the heating characteristics (i.e., focus size and effects of phase-amplitude and frequency steering) of the device concerned is possible. This study validates the predictions made by the treatment planning system Plan2Heat for various clinically used phased-array systems.</p><p><strong>Methods: </strong>The evaluated heating systems were AMC-2, AMC-4/ALBA-4D (Med-Logix srl, Rome, Italy), BSD Sigma-30, and Sigma-60 (Pyrexar Medical, Salt Lake City, UT, USA). Plan2Heat was used for specific absorption rate (SAR) simulations in phantoms representing measurement set-ups reported in the literature. SAR profiles from published measurement data based on E‑field or temperature rise were used to compare the device-specific heating characteristics predicted by Plan2Heat.</p><p><strong>Results: </strong>Plan2Heat is able to predict the correct location and size of the SAR focus, as determined by phase-amplitude settings and operating frequency. Measured effects of phase-amplitude steering on focus shifts (i.e., local SAR minima or maxima) were also correctly reflected in treatment planning predictions. Deviations between measurements and simulations were typically < 10-20%, which is within the range of experimental uncertainty for such phased-array measurements.</p><p><strong>Conclusion: </strong>Plan2Heat is capable of adequately predicting the heating characteristics of the AMC‑2, AMC-4/ALBA-4D, BSD Sigma-30, and Sigma-60 phased-array systems routinely used in clinical hyperthermia.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"135-150"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983218","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":"[Long-term results of the ORATOR-study: radiotherapy versus transoral robotic surgery for oropharyngeal cancer].","authors":"Alexander Fabian, Markus Hoffmann","doi":"10.1007/s00066-024-02335-2","DOIUrl":"10.1007/s00066-024-02335-2","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"201-203"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802311","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":"Determinants of radiation dose to immune cells during breast radiotherapy.","authors":"Pierre Loap, Jeremi Vu Bezin, Ludovic De Marzi, Youlia Kirova","doi":"10.1007/s00066-024-02240-8","DOIUrl":"10.1007/s00066-024-02240-8","url":null,"abstract":"<p><strong>Background: </strong>The immune system has been identified as an organ at risk in esophageal and lung cancers. However, the dosimetric impact of radiotherapy on immune system exposure in patients treated for breast cancer has never been studied.</p><p><strong>Methods: </strong>A monocentric retrospective dosimetric study included 163 patients treated at the Institut Curie (Paris, France) between 2010 and 2016 with locoregional helical tomotherapy after conservative surgery or total mastectomy. The effective dose to the immune system (EDIC) was calculated based on diverse dosimetric parameters. The clinical and volumetric determinants of EDIC in adjuvant radiotherapy of breast cancer were analyzed.</p><p><strong>Results: </strong>The median EDIC for the population was 4.23 Gy, ranging from 1.82 to 6.19 Gy. Right-sided radiotherapy and regional lymph node irradiation were associated with significantly higher EDIC in univariate (4.38 Gy vs. 3.94 Gy, p < 0.01, and 4.27 Gy vs. 3.44 Gy, p < 0.01, respectively) and multivariate analyses (p < 0.01 and p < 0.01). Liver overexposure was the main contributor to EDIC increase in right-sided breast cancer patients (+0.38 Gy [95%CI: +0.30; +0.46]), while the integral total dose increase was the main contributor to EDIC increase in cases of regional node irradiation (+0.63 Gy [95%CI: +0.42; +0.85]).</p><p><strong>Conclusion: </strong>The EDIC score during adjuvant radiotherapy after breast cancer was statistically significantly higher in the case of right-sided radiotherapy and regional lymph node irradiation. Liver irradiation is the main contributor to immune system exposure in adjuvant irradiation of right-sided breast cancer. Populations in which an association between EDIC and survival would exist have yet to be identified but could potentially include patients treated for triple-negative breast cancer with a poor response to neoadjuvant chemoimmunotherapy.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"106-114"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155419","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":"Regression of all untreated lesions in multifocal low-grade meningioma following fractionated stereotactic radiotherapy-abscopal effect or spontaneous regression? : Case report and review of the literature.","authors":"Michael Pinkawa, Jan Boström, Susanne Temming, Andreas Schäfer, Attila Kovács, Azize Boström","doi":"10.1007/s00066-024-02248-0","DOIUrl":"10.1007/s00066-024-02248-0","url":null,"abstract":"<p><strong>Purpose: </strong>Abscopal effects have been reported predominantly in metastatic cancers, indicating a radiographic response in a lesion that has not been included in the radiotherapy target volume. The response is interpreted as a humoral immune response to radiotherapy-generated tumour-specific antigens. In this case study, we present the first histologically confirmed multifocal low-grade meningioma with spontaneous regression of all other lesions after conventionally fractionated stereotactic radiotherapy (RT).</p><p><strong>Case report: </strong>Two localisations, right frontal and right spheno-orbital, were resected at the time of the initial diagnosis in a 66-year-old woman. RT was performed 1 year later to a progressive occipital lesion at the cerebral falx.</p><p><strong>Results: </strong>Regular magnetic resonance imaging (MRI) showed slightly decreasing tumour volume in untreated lesions 1 year after RT and continued during further follow-up. Up to > 7 years after treatment, MRI demonstrated an almost complete response of all initial lesions. Two prior reports with meningioma were published in one patient with an atypical meningioma after conventionally fractionated RT and another patient with an intracranial meningiomatosis after radiosurgery.</p><p><strong>Conclusion: </strong>This case study supports the concepts of treating only progressive or symptomatic meningioma lesions locally and careful regular MRI surveillance for further assessment. Potential active interventions to trigger an abscopal effect are currently not known. Further research of this beneficial effect for our patients should be supported.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"191-196"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318310","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":"Neoadjuvant chemoradiotherapy in combination with deep regional hyperthermia followed by surgery for rectal cancer: a systematic review and meta-analysis.","authors":"Adela Ademaj, Sonja Stieb, Cihan Gani, Oliver J Ott, Dietmar Marder, Roger A Hälg, Susanne Rogers, Pirus Ghadjar, Rainer Fietkau, Hans Crezee, Oliver Riesterer","doi":"10.1007/s00066-024-02312-9","DOIUrl":"10.1007/s00066-024-02312-9","url":null,"abstract":"<p><strong>Background and purpose: </strong>Combining chemoradiotherapy (CRT) with deep regional hyperthermia (HT) shows promise for enhancing clinical outcomes in selected rectal cancer patients. This study aimed to integrate the evidence and evaluate the efficacy of this combined treatment approach.</p><p><strong>Materials and methods: </strong>A systematic search of the PubMed, Scopus, and Mendeley databases was performed. This review was conducted according to the PRISMA guidelines. The quality of studies was evaluated using the Newcastle-Ottawa scale (NOS). Random-effects meta-analyses (DerSimonian and Laird) were performed. The primary outcome was pathological complete response (pCR), and secondary endpoints were overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), and toxicity.</p><p><strong>Results: </strong>In total, 12 studies were included, mostly of moderate quality. Patients with locally advanced rectal cancer (LARC; n = 760) and locally recurrent rectal cancer (LRRC; n = 22) were eligible. The pooled pCR rate was 19% (95% confidence interval [CI]: 16-22%) among all 782 patients and 19% (95%CI:16-23%) among 760 LARC patients. Due to significant study heterogeneity, survival outcomes were pooled by excluding LRRC patients. The pooled 5‑year OS rate among 433 LARC patients was 87% (95%CI: 83-90%). The pooled 5‑year DFS and LRFS in LARC patients were 75% (95%CI: 70-80%) and 95% (95%CI: 92-97%), respectively. There was a lack of consistent reporting of HT treatment parameters and toxicity symptoms among the studies.</p><p><strong>Conclusion: </strong>The collective clinical evidence showed that neoadjuvant CRT combined with HT in rectal cancer patients is feasible, with a 19% pCR rate and excellent survival outcomes in long term follow-up.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"151-162"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475205","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":"[Small dose-big effect? The use of low-dose radiation therapy (LDRT) in Alzheimer's disease (AD)].","authors":"Anna Fliedner, Lena Winterling, Rainer Fietkau, Lisa Deloch","doi":"10.1007/s00066-024-02336-1","DOIUrl":"10.1007/s00066-024-02336-1","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"204-206"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772403","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":"Initial needle tracking with the first standalone combined infrared camera - CT system for brachytherapy-analysis of tracking accuracy and uncertainties.","authors":"Andre Karius, Lisa Marie Leifeld, Vratislav Strnad, Claudia Schweizer, Rainer Fietkau, Christoph Bert","doi":"10.1007/s00066-024-02253-3","DOIUrl":"10.1007/s00066-024-02253-3","url":null,"abstract":"<p><strong>Purpose: </strong>A prototype infrared camera - cone-beam computed tomography (CBCT) system for tracking in brachytherapy has recently been developed. We evaluated for the first time the corresponding tracking accuracy and uncertainties, and implemented a tracking-based prediction of needles on CBCT scans.</p><p><strong>Methods: </strong>A marker tool rigidly attached to needles was 3D printed. The precision and accuracy of tool tracking was then evaluated for both static and dynamic scenarios. Euclidean distances between the tracked and CBCT-derived markers were assessed as well. To implement needle tracking, ground truth models of the tool attached to 200 mm and 160 mm needles were matched to the tracked positions in order to project the needles into CBCT scans. Deviations between projected and actual needle tips were measured. Finally, we put our results into perspective with simulations of the system's tracking uncertainties.</p><p><strong>Results: </strong>For the stationary scenario and dynamic movements, we achieved tool-tracking precision and accuracy of 0.04 ± 0.06 mm and 0.16 ± 0.18 mm, respectively. The tracked marker positions differed by 0.52 ± 0.18 mm from the positions determined via CBCT. In addition, the predicted needle tips in air deviated from the actual tip positions by only 1.62 ± 0.68 mm (200 mm needle) and 1.49 ± 0.62 mm (160 mm needle). The simulated tracking uncertainties resulted in tip variations of 1.58 ± 0.91 mm and 1.31 ± 0.69 mm for the 200 mm and 160 mm needles, respectively.</p><p><strong>Conclusion: </strong>With the innovative system it was possible to achieve a high tracking and prediction accuracy of marker tool and needles. The system shows high potential for applicator tracking in brachytherapy.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"163-172"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535323","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":"[Longterm outcome of definitive radiotherapy using IMRT vs. 3D-CRT in locally advanced, inoperable non-small cell lung cancer (NSCLC)].","authors":"Karim El-Marouk, Lukas Käsmann","doi":"10.1007/s00066-024-02327-2","DOIUrl":"10.1007/s00066-024-02327-2","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"198-200"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639688","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":"Navigating through recent evidence on locoregional breast cancer radiotherapy: an initiative by the scientific association of Swiss radiation oncology.","authors":"Pelagia G Tsoutsou, Anna-Lena Eberhardt, Günther Gruber, Guido Henke, Wendy Jeannerret-Sozzi, Claudia Linsenmeier, Kristina Lössl, Maria-Carla Valli, Walter P Weber, Kathrin Zaugg, Khalil Zaman, Daniel Zwahlen","doi":"10.1007/s00066-024-02332-5","DOIUrl":"10.1007/s00066-024-02332-5","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer (BC) is the most prevalent cancer in women and radiotherapy (RT) is an integral part of its treatment. High-level evidence guides clinical decisions, but given the abundance of guidelines, a need to navigate within the evidence has been identified by the board of the Scientific Association of Swiss Radiation Oncology (SASRO). A pilot project was initiated aiming to create an overview of recent clinically relevant evidence for BC RT, to make it easily available to (radiation) oncologists and radiation oncologists in training.</p><p><strong>Methods: </strong>A panel of 10 radiation oncology experts for BC RT, one expert in BC surgery, and one expert in BC medical oncology critically reviewed the relevant literature. The panel comprehensively represented different geographical regions of Switzerland as well as university, cantonal, and private institutions. We sought to create a consensual overview of the most relevant questions in BC RT today, accompanied by the most recent and relevant available evidence.</p><p><strong>Results: </strong>From January 2023 to January 2024, the panel met four times to review and work on an initial draft. The final draft was reviewed and accepted by all panelists. We hereby publish this work to make it available to international audiences. After publication, the work will be made available to all SASRO members on the SASRO website. This work is to be updated every 2 years.</p><p><strong>Conclusion: </strong>The identified need was addressed with a successful pilot project and will be further expanded upon in other tumor pathologies.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"93-105"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792115","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}