Strahlentherapie und Onkologie最新文献

{"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":"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":"173-184"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754379/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital redesign of the radiotherapy course for medical students with a blended learning approach.","authors":"Anne Caroline Knöchelmann, Jan-Niklas Becker, Gerald Stiller, Diana Steinmann, Marianne Behrends","doi":"10.1007/s00066-024-02348-x","DOIUrl":"https://doi.org/10.1007/s00066-024-02348-x","url":null,"abstract":"<p><strong>Purpose: </strong>Due to the need for high-quality teaching, we present a new blended learning concept combining digital modules, interactive seminars, and clinical experience. Furthermore, we evaluated its acceptance among students.</p><p><strong>Methods: </strong>A new concept for teaching was applied to the radiotherapy module and made available via the Hannover Medical School (MHH) learning management system as part of a blended learning concept with educational films, multimedia learning modules, online seminars, and onsite practical training. The evaluation recorded assessments of the requirement profile, design, and opportunities for skills acquisition; evaluation of the seminar and internship; and questions on the overall assessment.</p><p><strong>Results: </strong>The new concept was applied to four passes in the fourth academic year. A total of 152 students completed the radio-oncology learning module, which was evaluated by 46 students. Forty students considered the course duration to be appropriate for the material covered, and most students stated that their prior knowledge had been sufficient. The level of difficulty of the content was rated by the students as somewhat too high. The design of the digital course, the opportunity to acquire skills, the seminar course, and the practical course were mostly rated positively.</p><p><strong>Conclusion: </strong>Through digital redesign, a teaching concept can be implemented that combines self-determined learning, professional exchange with doctors, and clinical practice experience. The concept can be transferred to other areas because it combines theoretical knowledge transfer with synchronous teaching and clinical experience. The results of the evaluation show that the students rated the new concept well.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011763","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":"Analysis of radiation oncology integration within general practitioners' daily patient care: a cross-sectional survey in Germany.","authors":"Sophia M Leiss, Helen X Hou, Steffi Pigorsch, Kai Borm, Jan Peeken, Antonius Schneider, Stephanie Combs, Andreas Dinkel, Denise Bernhardt","doi":"10.1007/s00066-024-02352-1","DOIUrl":"https://doi.org/10.1007/s00066-024-02352-1","url":null,"abstract":"<p><strong>Purpose: </strong>General practitioners (GPs) play a crucial role in providing interdisciplinary care for radiation oncology patients. This study aims to understand the specific needs and challenges faced by general practitioners in Germany when treating oncology patients.</p><p><strong>Methods: </strong>A comprehensive web-based questionnaire with 24 items was disseminated to GPs in Germany via email using survio.com. The survey collected data on demographics, qualifications, clinical experiences, decision-making involvement, and symptom recognition. It specifically examined post-radiotherapy care and the use of specialized palliative homecare networks (SAPV). Statistical analyses were descriptive. The survey was open from July 4 to August 9, 2023.</p><p><strong>Results: </strong>A notable majority of general practitioners displayed confidence in their understanding of cancer-related symptoms, with over half (54.6%) rating their knowledge with 4 out of 5. This level of self-assessed expertise extended to their capacity to address the needs of cancer patients (53.8%), although 67% express a need for further education in specifically radiotherapeutic side effects. Satisfaction with SAPV networks was high, and 72.3% of respondents were actively involved in palliative care, compared to only 45.6% in managing radiation therapy. Notable challenges included inadequate communication with specialists, insufficient staffing, and under-recognition of GPs' roles in oncology care.</p><p><strong>Conclusion: </strong>The study highlights a paradox where GPs show high engagement in palliative care but limited involvement in radiation therapy management due to communication gaps and professional development needs. Addressing these disparities through targeted initiatives and fostering a collaborative care model is essential to amplify the important role of GPs, ensuring more integrated and effective patient care.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011758","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 combined with chemoimmunotherapy improves survival compared to chemoimmunotherapy alone as first-line treatment for oligometastatic esophageal squamous cell carcinoma.","authors":"Xiaoyan Lv, Shuai Wang, Wencheng Zhang, Qingsong Pang, Qiang Lin, Yajing Wu, Zhouguang Hui, Yueping Liu, Yunjie Cheng, Qing Liu, Jun Wang","doi":"10.1007/s00066-024-02347-y","DOIUrl":"https://doi.org/10.1007/s00066-024-02347-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety and efficacy of radiotherapy combined with chemoimmunotherapy (RCIT) versus chemoimmunotherapy (CIT) alone as first-line treatment for oligometastatic esophageal squamous cell carcinoma (OESCC) at initial diagnosis.</p><p><strong>Methods: </strong>We retrospectively evaluated 140 patients newly diagnosed with OESCC who received RCIT or CIT as first-line treatment between June 2018 and December 2021. Among them, 76 patients were in the RCIT cohort and 64 patients in the CIT cohort. Propensity score matching (PSM) was used to simulate random allocation.</p><p><strong>Results: </strong>After 1:1 PSM, 61 well-paired patients were selected. The median follow-up duration was 34.7 months (95%CI: 30.6-38.8 months). After PSM, the median PFS for the RCIT and CIT groups was 10.9 (95%CI: 9.4-12.4) months and 7.3 (95%CI: 6.0-8.7) months, respectively (P = 0.004). The median OS for the RCIT and CIT groups was 22.4 (95%CI: 17.5-27.4) months and 13.4 (95%CI: 10.9-15.9) months, respectively (P = 0.031). There were significant differences in PFS (median PFS: 12.9 vs. 8.6 vs. 7.3 months, P = 0.003) between the group receiving radiotherapy (RT) for all lesions, the group receiving RT for partial lesions, and the CIT group, while OS was on the threshold of significance (median OS: 29.4 vs. 17.3 vs. 13.4 months, P = 0.052). No significant differences in the incidence of grade 3 or higher (G3+) treatment-related adverse events (TRAEs) were observed between the two groups. However, the incidence of G3+ pneumonitis (13.1% vs 1.6%, P = 0.038) were higher in the RCIT group compared to the CIT group.</p><p><strong>Conclusion: </strong>RCIT as first-line treatment for OESCC was safe and efficacious. RCIT improved PFS/OS compared to CIT without increasing the overall high grade toxicity rate. However, the increased incidence of pneumonitis due to RT implementation cannot be disregarded.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979879","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":"Prognostic significance of the mEPE score in intermediate-risk prostate cancer patients undergoing ultrahypofractionated robotic SBRT.","authors":"Lucas Mose, Laura Isabel Loebelenz, Alexander Althaus, Maiwand Ahmadsei, Etienne Mathier, Isabelle Broemel, Daniel M Aebersold, Verena Carola Obmann, Mohamed Shelan","doi":"10.1007/s00066-024-02355-y","DOIUrl":"https://doi.org/10.1007/s00066-024-02355-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the prognostic significance of magnetic resonance imaging (MRI) parameters on biochemical failure-free survival (BFS) in patients diagnosed with intermediate-risk prostate cancer and treated with robotic ultrahypofractionated stereotactic body radiotherapy (SBRT) without androgen deprivation therapy (ADT).</p><p><strong>Methods: </strong>A retrospective analysis was conducted in patients with intermediate-risk prostate cancer undergoing robotic SBRT delivered in five fractions with a total radiation dose of 35-36.25 Gy. The primary endpoint was biochemical failure as defined by the Phoenix criteria. Among other clinicopathological data, T stage, Prostate Imaging-Reporting and Data System (PI-RADS) score, and multiparametric magnetic resonance imaging-based extra-prostatic extension (mEPE) score were collected and analyzed using the log-rank test.</p><p><strong>Results: </strong>A total of 74 patients were eligible for analysis. Median age at treatment was 68.8 years and median prostate volume was 47.8 cm³. Fifty-four and 14 patients were diagnosed with Gleason scores 7a and 7b, respectively. In total, 40 patients were classified as having unfavorable intermediate-risk prostate cancer according to American Urological Association/American Society for Radiation Oncology/ Society of Urologic Oncology (AUA/ASTRO/SUO) guidelines. The median follow-up was 30 months (range: 4-91.2 months; interquartile range (IQR): 18.5-48 months). The 3‑year BFS was 92%. A total of 12 (16.2%) biochemical failures were reported. In univariate analysis, an mEPE score of 5, the delivered total radiation dose (35 Gy vs. 36.25 Gy), and a prostate-specific antigen (PSA) nadir >1 ng/ml were associated with lower BFS (mEPE-BFS: p < 0.001, total radiation dose-BFS: p = 0.04, PSA nadir-BFS: p =< 0.001).</p><p><strong>Conclusion: </strong>Patients diagnosed with intermediate-risk prostate cancer with a high mEPE score are more likely to experience biochemical failure after SBRT. Treatment intensification measures, such as administration of concomitant ADT, should be considered.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984827","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":"PET/CT-based target volume definition in involved-site radiotherapy for treatment of early-stage nodal follicular lymphoma.","authors":"Antje Wark, Ji-Young Kim, Elena Mavriopoulou, Christian la Fougère, Thomas Wiegel, Christian W Scholz, Christian Baues, Minglun Li, Thomas Gauler, Stephanie E Combs, Klaus Herfarth","doi":"10.1007/s00066-024-02356-x","DOIUrl":"https://doi.org/10.1007/s00066-024-02356-x","url":null,"abstract":"<p><strong>Purpose: </strong>Recent advancements in imaging, particularly 18F-fluorodeoxyglucose positron-emission tomography-computed tomography (FDG-PET/CT), have improved the detection of involved lymph nodes, thus influencing staging accuracy and potentially treatment outcomes. This study is a post hoc analysis of the GAZAI trial data to evaluate the impact of FDG-PET/CT versus computed tomography (CT) alone on radiation target volumes for involved-site radiotherapy (IS-RT) in early-stage follicular lymphoma (FL).</p><p><strong>Methods: </strong>All patients in the GAZAI trial underwent pretherapeutic FDG-PET/CT examinations, which were subject to central quality control. Lymph nodes with pathological metabolism were assessed for CT morphology. Differential regional involvement and the impact on radiation target volume for IS-RT were compared between PET/CT-based to solely CT-based staging.</p><p><strong>Results: </strong>In 54 patients with PET-positive lymph nodes after initial surgery, 170 involved lymph nodes were identified in total. FDG-PET/CT identified additionally involved lymph nodes not detected by CT in 61% of the patients, leading to a significant change in radiation treatment fields for 30% of the cohort. Only 58% of all involved lymph nodes exhibited pathological CT morphology. The findings were robust across different Deauville score thresholds and CT morphological metrics.</p><p><strong>Conclusion: </strong>The findings confirm the essential role of FDG-PET/CT in accurately defining the radiation volume for treatment of early-stage follicular lymphomas with radiotherapy. These results support the integration of FDG-PET/CT into the standard diagnostic pathway and its inclusion in the service catalogue of statutory health insurance, emphasizing its importance for optimal treatment planning and the potential impact on patient outcomes.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979871","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":"Simultaneous integrated boost to lateral pelvic lymph nodes during chemoradiotherapy in high-risk rectal cancer.","authors":"Marcel Büttner, Simon Böke, Sabrina Baumeister, Robert Bachmann, Michael Bitzer, Hans Bösmüller, Dörte Wichmann, Maximilian Niyazi, Cihan Gani","doi":"10.1007/s00066-024-02354-z","DOIUrl":"https://doi.org/10.1007/s00066-024-02354-z","url":null,"abstract":"<p><strong>Background: </strong>Preoperative chemoradiotherapy combined with total mesorectal excision (TME) is a standard treatment for locally advanced rectal cancer (LARC). However, lateral pelvic lymph nodes (LPLNs) are often inadequately treated with standard regimens. This study examines the treatment and postoperative outcomes in LARC patients receiving a simultaneous integrated boost (SIB) for LPLNs during long-course chemoradiotherapy.</p><p><strong>Methods: </strong>This retrospective study included high-risk LARC patients (UICC, \"Union Internationale Contre le Cancer\", stage III) treated with preoperative chemoradiotherapy and SIB to LPLNs. Radiotherapy was delivered to the primary tumor and elective volumes with 50.4 Gy in 28 fractions, and an SIB with a median dose of 60.2 Gy was administered to clinically positive LPLNs. TME quality and postoperative complications were assessed using MERCURY and Clavien-Dindo, respectively. Time-to-event data were analyzed according to Kaplan-Meier.</p><p><strong>Results: </strong>Between 2019 and 2023, 27 patients with high-risk LARC and LPLN metastases were treated with chemoradiotherapy. After a median follow-up of 19 months, 2‑year overall survival was 80%, disease-free survival 80%, and local control of dose-escalated lymph nodes 100%. Three patients were managed nonoperatively after a clinical complete response on endoscopy and imaging. Of the 22 patients who had surgery, only one had complications higher than Clavien-Dindo grade I; TME was graded as MERCURY I in 73%.</p><p><strong>Discussion and conclusion: </strong>The SIB approach for LPLNs in LARC is feasible, does not increase postoperative morbidity, and achieves excellent local control. This study supports the consideration of dose-escalated radiotherapy for LPLNs to address high local recurrence risks.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979880","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":"Prostate motion in magnetic resonance imaging-guided radiotherapy and its impact on margins.","authors":"Johannes Kusters, René Monshouwer, Peter Koopmans, Markus Wendling, Ellen Brunenberg, Linda Kerkmeijer, Erik van der Bijl","doi":"10.1007/s00066-024-02346-z","DOIUrl":"10.1007/s00066-024-02346-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study focused on reducing the margin for prostate cancer treatment using magnetic resonance imaging-guided radiotherapy by investigating the intrafractional motion of the prostate and different motion-mitigation strategies.</p><p><strong>Methods: </strong>We retrospectively analyzed intrafractional prostate motion in 77 patients with low- to intermediate-risk prostate cancer treated with five fractions of 7.25 Gy on a 1.5 T magnetic resonance linear accelerator. Systematic drift motion was observed and described by an intrafractional motion model. The planning target volume (PTV) margin was calculated in a cohort of 77 patients and prospectively evaluated for geometric coverage in a separate cohort of 24 patients.</p><p><strong>Results: </strong>The intrafractional model showed that the prostate position starts out of equilibrium for the anterior-posterior (-1.8 ± 3.1 mm) and superior-inferior (1.7 ± 2.6 mm) directions, with relaxation times of 12 and 15 min, respectively. Position verification scans are acquired at 30 min on average. At that time, the transient drift motion becomes indistinguishable from the residual random intrafractional motion. PTV margins can be reduced to 1.8 mm (left-right), 3.2 mm (anterior-posterior), and 2.9 mm (superior-inferior). Evaluation of the overlap with the clinical target volume (CTV) was performed for a total of 120 fractions of 24 patients. The overlap range between the CTV and the PTV was 93-100% and the applied 3‑mm PTV margin for the CTV had a 99.5% averaged geometric overlap for all patients.</p><p><strong>Conclusion: </strong>A PTV margin reduction to 3 mm is feasible. A patient-specific approach could reduce the margins further.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979877","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":"Predicting acute and late toxicity in prostate cancer stereotactic ablative radiotherapy: the role of dosimetric parameters and prostate volume.","authors":"Gokhan Ozyigit, Pervin Hurmuz, Pantea Bayatfard, Burak Tilki, Yagiz Yedekci, Melek Tugce Yilmaz","doi":"10.1007/s00066-024-02343-2","DOIUrl":"https://doi.org/10.1007/s00066-024-02343-2","url":null,"abstract":"<p><strong>Purpose: </strong>Our objective was to identify the dosimetric parameters and prostate volume that most accurately predict the incidence of acute and late gastrointestinal (GI) and genitourinary (GU) toxicity in prostate cancer stereotactic ablative radiotherapy (SABR) treatments.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 122 patients who received SABR for prostate cancer at our clinic between March 2018 and September 2022 using a five-fraction SABR regimen. The existing plans of these patients were re-evaluated according to our institutional protocols (Hacettepe University [HU-1] and HU-2) as well as PACE‑B, RTOG 0938, and NRG GU005 dose-volume constraints. Univariate and multivariate logistic regression analyses were performed using SPSS version 23.0 (IBM, Armonk, NY, USA).</p><p><strong>Results: </strong>The median follow-up was 24.7 months (0.8-94.4 months). For acute GU toxicity, moderate-dose regions were predictive for grade 1-2 toxicity, while high-dose regions were more associated with grade 3-4 toxicity. For late GU toxicity, moderate-high-dose regions were predictive. For GI toxicity, moderate-dose regions were important for both acute and late toxicity. The HU protocol encompassed all significant dosimetric factors influencing toxicity outcomes. A prostate volume threshold of 60 cc was predictive of acute grade 3-4 GU toxicity.</p><p><strong>Conclusion: </strong>Our study highlighted the critical role of moderate-dose regions for acute and late GI and GU toxicity. Prostate treatment plans should be rigorously evaluated, and moderate doses should be minimized. The HU protocol is an eligible choice for five-fraction SABR plans.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955397","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":"Linear regression analysis for complete blood count parameters during radiotherapy.","authors":"Aniwat Berpan, Nattapatch Janhom","doi":"10.1007/s00066-024-02344-1","DOIUrl":"https://doi.org/10.1007/s00066-024-02344-1","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the correlations between complete blood count (CBC) during radiotherapy and patient and treatment factors.</p><p><strong>Patients and methods: </strong>Data of cancer patients, including age, sex, concurrent chemotherapy (CCRT), radiotherapy dose (equivalent dose in 2‑Gy fractions with an alpha/beta value of 10 Gy, EQD2Gy10), radiotherapy location, and baseline CBC were collected. Linear regression was used to determine results during radiation. Validation data comprised 20% of the whole cohort.</p><p><strong>Results: </strong>A total of 496 radiotherapy courses and 1884 weekly CBC results during treatment were analyzed. Baseline hemoglobin (Hb) was positively associated with subsequent Hb. Each 1 g/dL increase in baseline Hb predicted a 0.73 g/dL increase in Hb during treatment (95% confidence interval [CI] 0.7-0.76). Male sex was associated with a 0.16 g/dL higher Hb (95% CI 0.04-0.29), while female sex showed the opposite trend. CCRT was associated with a 0.18 g/dL reduction in Hb (95% CI -0.33 to -0.03). Radiotherapy to the pelvis, bone, and head and neck regions resulted in Hb reductions of 0.18, 0.34, and 0.94 g/dL, respectively (95% CI -0.33 to -0.03, -0.53 to -0.15, and -1.26 to -0.62, respectively), while brain irradiation increased Hb by 0.22 g/dL (95% CI 0.05-0.38). Age, cumulative dose, and thoracic irradiation did not show a significant correlation with Hb changes. Adjusted R‑squared for the development and validation data were 0.6 and 0.71 for Hb, 0.42 and 0.11 for white blood cell count, 0.36 and 0.32 for neutrophils, 0.42 and 0.06 for absolute neutrophil count, and 0.43 and 0.36 for platelets, respectively.</p><p><strong>Conclusion: </strong>Hb levels during radiotherapy could be explained using linear regression, although they did not negatively correlate with cumulative dose.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955457","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}