Strahlentherapie und Onkologie最新文献

{"title":"Sustainability in German radiotherapy: professionals' perspectives on energy savings-results of a DEGRO working group survey.","authors":"Ann-Katrin Exeli, Andreas Lurtz, Daniel Medenwald, Linda Agolli, Daniel Habermehl","doi":"10.1007/s00066-026-02544-x","DOIUrl":"10.1007/s00066-026-02544-x","url":null,"abstract":"<p><strong>Purpose: </strong>The healthcare sector is a major source of carbon dioxide (CO₂) emissions, with radiotherapy (RT) being a particularly significant contributor due to its high energy consumption and patient-related travelling. Our survey aimed to gather opinions on energy savings and CO₂ reduction in various RT areas. We asked radiation oncologists and medical physicians about the importance of these issues in their day-to-day work as well as about their personal views on them.</p><p><strong>Methods: </strong>An online survey was conducted via the German Society for Radiooncology (DEGRO) mailing list. The questionnaire covered demographics, attitudes toward energy-saving measures, and current clinical use of (ultra-)hypofractionation (UHF). Quantitative data were analyzed descriptively; free-text responses were thematically summarized.</p><p><strong>Results: </strong>A total of 69 questionnaires were completed. Attitudes toward sustainability in RT were largely positive: almost 80% believed that topics such as climate protection and energy transition could influence future departmental decisions, and 77% considered sustainable manufacturing and maintenance by linear accelerator providers important. Over 95% reported using UHF regimens. Moderate hypofractionation was the standard for breast (77%) and prostate cancer (55%), while longer schedules remained common for bone metastases (62%). Moreover, 58% indicated willingness to expand UHF use, provided no medical disadvantages occurred.</p><p><strong>Conclusion: </strong>There are broad awareness and support for sustainability in RT among German professionals. However, practical implementation of environmentally beneficial measures, such as UHF, remains constrained. Addressing systemic barriers and improving access to environmental impact data may facilitate more sustainable clinical workflows.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"803-808"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296271","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":"Unsupervised clustering analysis unravels the role of systemic inflammatory indices in the prognosis of patients with locally advanced cervical cancer treated with chemoradiation.","authors":"Savino Cilla, Federica Medici, Martina Ferioli, Alessandra Arcelli, Anna Myriam Perrone, Milly Buwenge, Pierandrea De Iaco, Alessio Giuseppe Morganti","doi":"10.1007/s00066-026-02513-4","DOIUrl":"10.1007/s00066-026-02513-4","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study aimed to predict the treatment outcomes and survival of patients with locally advanced cervical cancer (LACC) receiving chemoradiotherapy (CRT) using an unsupervised clustering machine learning method.</p><p><strong>Materials and methods: </strong>This retrospective study was based on a cohort of 152 consecutive patients. Treatment consisted of definitive CRT, combining external beam radiotherapy to the pelvis with intracavitary brachytherapy to achieve a total equivalent dose of 85-90 Gy at the tumor site. Patient-related data including age, body mass index, standard blood tests and complete blood count were recorded before CRT. Various inflammatory indices were analyzed, including the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), leukocyte-lymphocyte ratio (LLR), systemic immune inflammation index (SII), and aspartate aminotransferase (AST) to neutrophil ratio index (ANRI). Based on these covariates, an unsupervised clustering method based on the agglomerative hierarchical clustering (AHC) algorithm was used to identify clusters of patients. The groups of patients were compared in terms of local control (LC), disease-free survival (DFS), distant metastases-free survival (DMFS), and overall survival (OS). A Cox proportional hazard regression analysis was performed to evaluate the relationship between the clusters and the clinical outcomes.</p><p><strong>Results: </strong>Clustering analysis reported an optimal number of clusters equal to two. Analysis of variance indicated that the variables contributing most to the separation of the clusters were SII, LLR, ANRI, PLR, NLR, hemoglobin, and white cells count. Significant differences were found between the two groups of lesions in terms of LC (p < 0.001), DFS (p = 0.019), and OS (p = 0.017). At 2 years, LC, DFS, and OS were 93.5%, 72.0%, and 93.1%, and 92.7%, 72.0%, and 70.8% for clusters 1 and 2, respectively. In the unadjusted Cox model, patients in cluster 1 were significantly more likely to experience higher local control (HR 3.88 [95% CI 1.80-8.37]; p = 0.001), disease-free survival (HR 1.97 [95% CI 1.10-3.51]; p = 0.022), and overall survival (HR 2.16 [95% CI 1.13-4.14]; p = 0.021).</p><p><strong>Conclusion: </strong>This study highlights the predictive value of blood parameters and inflammatory indexes for risk stratification in LACC. An unsupervised clustering approach is able to stratify the treatment outcomes with significant performance.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"895-904"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474777","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":"Evaluation of a merging-based approach for improving patient-specific quality assurance in proton and carbon-ion radiotherapy: a comparative study with conventional single-isocentre experience.","authors":"Yixiao Guo, Kai Wang, Wen Du, Yahan Yang, Zhanlin Luo, Xiaojun Liu, Bo Li, Li He, Hongyi Cai","doi":"10.1007/s00066-026-02527-y","DOIUrl":"10.1007/s00066-026-02527-y","url":null,"abstract":"<p><strong>Background and purpose: </strong>Ionization chamber arrays are inherently limited in spatial resolution, which can lead to the underdetection of potential clinical errors in particle therapy. The study aimed to validate the clinical efficacy of a multi-position dose merging approach, evaluating its capacity to enhance spatial resolution and improve error detection sensitivity relative to conventional single-isocentre quality assurance (QA) protocols.</p><p><strong>Methods: </strong>Dose distributions were measured using PTW 729 ^XDR and 1500 ^XDR ionization chamber arrays at three clinically relevant depths within the spread-out Bragg peak (SOBP) region. Two datasets were generated: a merged dataset formed by combining dose distributions acquired at the isocentre and at the 5‑mm detector shifts (lateral x‑axis shifts for the 729 ^XDR array and longitudinal y‑axis shifts for the 1500 ^XDR array), and a single-isocentre dataset. The translational accuracy of the treatment couch was verified using a laser alignment system and a graduated scale. Bland-Altman analysis was performed to quantify the agreement and relative bias (%) between the merged and single-isocentre approaches. The receiver operating characteristic (ROC) curve was employed to compare the sensitivity of the two methods in detecting intentional 1 and 2 mm range errors.</p><p><strong>Results: </strong>The single-isocentre cohort showed higher mean gamma pass rates (n = 2616) than the merged cohort (P < 0.05). The merging method resulted in a greater reduction in gamma passing rates for carbon-ion and pencil beam scanning (PBS) dose verification compared to proton and uniform scanning dose verification (3.85% for carbon-ion versus 1.93% for proton; 3.49% for PBS versus 1.69% for uniform scanning). Bland-Altman analysis revealed a 95% limits of agreement (LoA) width of 5.28% between the two methods under 3%/2 mm gamma criteria with global normalization. ROC analysis demonstrated that the merging method yielded greater sensitivity for detecting 1 and 2 mm range errors than the single-isocentre approach, improving sensitivity for detecting 2 mm errors by 19.06% in carbon-ion therapy versus 6.69% in proton therapy.</p><p><strong>Conclusion: </strong>The spatial resolution limitations of conventional detector arrays may artificially inflate gamma pass rates, introducing a risk of false-negative approval for clinically unacceptable treatment plans. The multi-position dose merging approach mitigates this limitation by enhancing spatial resolution, supporting its clinical utility as a practical, workflow-integratable strategy to improve the accuracy and effectiveness of proton and carbon-ion radiotherapy QA protocols.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"838-851"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869433","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":"Pelvic insufficiency fractures in cervical cancer patients treated with definitive chemoradiation: impact of dosimetric and clinical factors.","authors":"Rosa Autorino, Raffaella Michela Rinaldi, Davide Cusumano, Luca Russo, Benedetta Gui, Viola De Luca, Roberta Giannini, Maura Campitelli, Valentina Lancellotta, Gabriella Macchia, Nicolò Bizzarri, Maria Antonietta Gambacorta","doi":"10.1007/s00066-026-02518-z","DOIUrl":"10.1007/s00066-026-02518-z","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to investigate the correlation between clinical and dosimetric factors and the incidence of pelvic insufficiency fractures (PIFs) in patients with cervical cancer treated with radical radiotherapy (RT), with or without chemotherapy, and to identify dose constraints that may reduce this risk.</p><p><strong>Methodology: </strong>We reviewed data from cervical cancer patients treated with pelvic external-beam RT at our institution between 2020 and 2023. For each patient, pelvic bone marrow (BM) was contoured and divided into three subsites: lumbosacral spine (LSBM), ilium (IBM), and lower pelvis (LPBM). Data on the volume of each region receiving 10, 20, 30, and 40 Gy (V10, V20, V30, and V40, respectively) and D_mean were collected.</p><p><strong>Results: </strong>A total of 202 patients were retrospectively analyzed. Of these, 36 patients (17.8%) developed PIFs in the treatment field, with most cases being asymptomatic. Our analysis indicates that V40 of the LPBM is the most significant dosimetric parameter. When combined with patient age, this parameter stratifies the risk of fracture development according to the V40 value, thereby accounting for the patient's age in the risk assessment.</p><p><strong>Conclusion: </strong>This preliminary study allowed us to identify the dose constraints to reduce the risk of PIF according to patient age. Further investigations are needed to confirm these findings by including these parameters in the planning process.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"888-894"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989105","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":"[Topical fullerene for preventing acute radiation dermatitis in head and neck cancer].","authors":"Lukas Käsmann, Cas Stefaan Dejonckheere","doi":"10.1007/s00066-026-02543-y","DOIUrl":"10.1007/s00066-026-02543-y","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"905-907"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781702","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":"Proton beam therapy versus trans-arterial chemoembolization for BCLC stage B hepatocellular carcinoma-a propensity-matched analysis.","authors":"Tzu-Ting Liu, Bing-Shen Huang, Yu-Ming Wang, Chieh-Min Liu, Eng-Yen Huang, Hsin-You Ou, Tsung-Hui Hu, Sheng-Nan Lu, Chao-Hung Hung, Yen-Hao Chen, Chung-Shih Chen, Jen-Yu Cheng","doi":"10.1007/s00066-025-02495-9","DOIUrl":"10.1007/s00066-025-02495-9","url":null,"abstract":"<p><strong>Purpose: </strong>Proton beam therapy (PBT) has a promising local control rate, but clinical data supporting its use for intermediate-stage hepatocellular carcinoma (HCC) remains insufficient, and its survival benefit over transarterial chemoembolization (TACE) has yet to be established. This study aimed to compare the two modalities by evaluating real-world survival outcomes.</p><p><strong>Methods: </strong>The propensity score-matched (PSM) cohort study used data from a multi-institutional medical research database. Treatment-naïve patients with Barcelona Clinic Liver Cancer (BCLC) stage B HCC who underwent PBT or TACE as monotherapy were enrolled. Baseline patient and tumor characteristics were used for matching. Overall survival (OS) and post-treatment albumin-bilirubin (ALBI) grade were assessed, and stratified analyses were performed to evaluate the heterogeneity.</p><p><strong>Results: </strong>Between January 2007 and December 2022, 4349 patients with BCLC‑B HCC were identified, 1172 of whom met the inclusion criteria (PBT: 68; TACE: 1104). The PSM cohort matched 340 patients (PBT: 68; TACE: 272). Cox regression analysis revealed a significant survival benefit in the PBT group (p = 0.032, hazard ratio (HR) 0.64, 95% CI 0.42-0.97). Liver function was assessed in terms of ALBI grade every 3 months for 12 months after treatment, and the proportion of patients who maintained better liver function was greater in the PBT group than in the TACE group (p = 0.006).</p><p><strong>Conclusion: </strong>For patients with BCLC‑B HCC who are suitable candidates for PBT, PBT preserves better liver function than TACE and provides superior OS.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"852-861"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649505","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":"Perirectal spacers and endorectal balloons in external beam radiotherapy for prostate cancer: a review of prospective studies.","authors":"Matthias Moll, Nancy P Mendenhall, Gregor Goldner, Marcin Miszczyk, Sushant Sushant, Carola Lütgendorf-Caucig, Eugen Hug, William M Mendenhall","doi":"10.1007/s00066-026-02545-w","DOIUrl":"10.1007/s00066-026-02545-w","url":null,"abstract":"<p><strong>Purpose: </strong>Endorectal balloons (ERB) and perirectal spacers (RS) were developed to minimize rectal toxicity in prostate cancer radiotherapy. We conducted a review to assess available data.</p><p><strong>Methods and materials: </strong>Literature search was conducted on 20th May, 2025, using PubMed. Prospective studies and meta-analyses assessing the efficacy of ERB and PRS on rectal toxicity were included. Risk of bias was evaluated (MINORS and Cochrane Risk of Bias). Other relevant publications, guideline recommendations and cost-effectiveness analyses were reviewed and summarized narratively.</p><p><strong>Results: </strong>Of 112 identified records, 66 studies met the inclusion criteria, including 44 reports on RS (n = 4581 patients excluding reviews), 16 reports on ERB (n = 829) and six on both RS and ERB (n = 105, excluding reviews). This included nine publications on RS (n = 383), 12 publications on ERB (n = 204), and 3 original publications on both RS and ERB (n = 105) reporting on dosimetry. For RS, most publications covered hydrogel, 11 balloon and 7 hyaluronic acid. 30 publications reported follow-up data, with 8 studies reporting a median follow-up ≥ 24 months and one of more than five years. 35 publications reported clinical outcomes. We identified 2 RCTs. RS improves bowel QoL, but only one found a reduction of gastrointestinal G1 toxicity. For ERB, 12/16 studies were dosimetry studies, with 4 studies reporting clinical outcomes. One RCT was identified, with ERB providing a dosimetric benefit that also translates into reduced rectal late toxicity. The longest reported follow-up was 31 months median. 7/16 studies report 3D-conformal results. One study covering ERB and RS compared both modalities alone directly dosimetrically, showing an advantage for RS.</p><p><strong>Conclusions: </strong>Overall, prospective data quality for different tools for rectal management is poor, especially regarding late toxicity, and particularly for ERBs. Evidence for late-toxicity superiority remains scarce. Both show benefits over not using any device at all.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"809-837"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989111","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":"Total neoadjuvant therapy with dose-escalated radiotherapy for organ preservation in locally advanced rectal cancer: real-world outcomes.","authors":"O Hernando-Requejo, M López González, C Saiz Guisasola, E Sánchez Saugar, A Montero Luis, R Ciervide Jurio, X Chen Zao, B Álvarez Rodríguez, J Valero Albarran, M García-Aranda Pez, R Alonso Gutiérrez, C Rubio Rodríguez","doi":"10.1007/s00066-026-02526-z","DOIUrl":"10.1007/s00066-026-02526-z","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the role of total neoadjuvant therapy (TNT) in locally advanced rectal cancer, focusing on its impact on compliance, tumor downstaging, and organ preservation when combined with watch-and-wait (W&W) protocols and to assess whether radiotherapy dose escalation may increase clinical complete response (cCR) rates.</p><p><strong>Methods: </strong>We retrospectively analyzed 135 patients with locally advanced rectal cancer treated with TNT and radiotherapy dose escalation (57.5 Gy to the tumor and nodes in 23 fractions) between 2015 and 2024. Patients achieving cCR were considered for the W&W strategy. Outcomes included tumor response, local control, disease-free survival (DFS), and toxicity. Prognostic factors were explored through univariate and multivariate analyses.</p><p><strong>Results: </strong>A total of 48.9% achieved cCR and were managed nonoperatively, while 51.1% underwent surgery. Local control at 3 years was 83.5%, with local regrowth significantly higher in the W&W group (33.1%) than the rate of local recurrences in the surgical cohort (6.5%, p = 0.001). Poorer local control was associated with low rectal tumors, local regrowth, and the development of metachronous metastases. Disease-free survival at 3 years was 69.2%, with better outcomes in patients who underwent surgery or were included in the W&W strategy based on multidisciplinary consensus. No acute or chronic radiotherapy-related toxicity greater than grade 3 was observed. In multivariate analysis, local regrowth and nonconsensual W&W inclusion remained independent predictors of impaired DFS and metastasis-free survival.</p><p><strong>Conclusion: </strong>Total neoadjuvant therapy with radiotherapy dose escalation is effective and well tolerated. Tumor location, local regrowth, and the role of multidisciplinary decision-making are critical prognostic factors. Careful patient selection and structured follow-up are essential to optimize outcomes in the W&W strategy. Although functional and quality of life outcomes were not assessed, future prospective studies should incorporate these measures to further strengthen organ-preservation approaches.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"869-881"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781690","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":"Evaluation of a novel abdominal compression airbag for respiratory motion management and setup reproducibility in upper abdominal radiotherapy.","authors":"Yinghua Shi, Huidong Wang, Lijuan Ding, Minghui Sun, Peilin Li, Wei Hou, Yu Li, Yan Gao, Wuji Sun","doi":"10.1007/s00066-026-02577-2","DOIUrl":"https://doi.org/10.1007/s00066-026-02577-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the clinical feasibility and efficacy of a novel abdominal compression airbag (ACA) for respiratory motion management and setup reproducibility in upper abdominal radiotherapy and to compare its performance against free breathing (FB) and the standard abdominal compression plate (ACP).</p><p><strong>Methods: </strong>A total of 54 patients with upper abdominal malignancies were retrospectively analyzed in three groups based on the FB, ACP, and ACA motion management strategies. Respiratory motion amplitude was quantified by calculating the displacement of the liver centroid between the 0% and 50% phases of four-dimensional CT scans. Interfractional setup reproducibility was assessed by analyzing setup errors derived from pretreatment cone-beam CT (CBCT) scans. Statistical comparisons for the respiratory motion amplitude were performed using the Kruskal-Wallis test followed by Dunn's post-hoc test. The analysis of setup stability utilized a linear mixed-effects model.</p><p><strong>Results: </strong>Both ACP and ACA significantly attenuated respiratory motion compared to FB (p < 0.001). The mean vectorial motion amplitudes were 0.88 ± 0.20 cm, 0.61 ± 0.24 cm, and 0.57 ± 0.19 cm for the FB, ACP, and ACA groups, respectively. No significant difference in motion restriction was found between ACA and ACP. In terms of setup reproducibility, the ACA group demonstrated superior stability in the anterior-posterior direction, with the lowest mean absolute error (0.15 ± 0.11 cm), but exhibited larger errors in the left-right direction (0.32 ± 0.22 cm) compared to both FB (0.18 ± 0.15 cm) and ACP (0.19 ± 0.15 cm).</p><p><strong>Conclusion: </strong>The ACA achieved a motion restriction performance comparable to the standard ACP, but it was associated with increased uncertainty in the left-right direction. The ACA could serve as a practical alternative with potential workflow and compatibility advantages, preferably coupled with robust image-guided verification to maintain setup stability.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580209","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":"[Hypofractionated split-course radiotherapy in frail older patients with head and neck squamous cell carcinoma].","authors":"Alexander Rühle, Nils H Nicolay","doi":"10.1007/s00066-026-02578-1","DOIUrl":"https://doi.org/10.1007/s00066-026-02578-1","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550391","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}