Strahlentherapie und Onkologie最新文献

{"title":"The estimated dose of radiation to immune cells predicts lymphopenia and reveals technique-Dependent immune sparing in postoperative radiotherapy for early esophageal cancer.","authors":"Yiwen He, Xianhu Zeng, Linsen Zhou, Xiaobin Wang, ShiYan Sheng, Jiantao Wang","doi":"10.1007/s00066-026-02576-3","DOIUrl":"https://doi.org/10.1007/s00066-026-02576-3","url":null,"abstract":"<p><strong>Background: </strong>Radiation-induced lymphopenia (RIL) affects patient survival, but previous studies have mostly focused on locally advanced patients receiving chemoradiotherapy, which involves many confounding factors. This study aimed to investigate whether the estimated dose of radiation to immune cells (EDRIC) correlates with hematologic toxicity (especially lymphopenia) in early-stage esophageal squamous cell carcinoma (ESCC) patients treated with postoperative radiotherapy alone, and to compare EDRIC differences among four modern radiotherapy techniques.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 30 patients with early-stage ESCC who received postoperative radiotherapy (5040 cGy in 28 fractions) between 2020 and 2025. None of the patients received chemotherapy or immunotherapy, ensuring treatment homogeneity. EDRIC was calculated using the Ladbury formula. Four treatment plans-intensity-modulated radiotherapy (IMRT), volumetric-modulated arc therapy (VMAT), intensity-modulated proton therapy (IMPT), and spot scanning proton arc therapy (SPArc)-were generated for each patient in the RayStation system. EDRIC values were compared using the Friedman test followed by Bonferroni-corrected Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>Complete blood count data were available for 14 of the 30 patients. In this exploratory analysis, only the absolute lymphocyte count (ALC) showed a significant correlation with EDRIC (adjusted R² = 0.727, 95% CI: 0.35-0.91, P < 0.001). Moreover, after adjusting for baseline ALC, multivariate regression indicated that EDRIC remained associated with the nadir ALC (P = 0.004). EDRIC outperformed mean lung dose (adjusted R² = 0.428), mean heart dose (adjusted R² = 0.482), and mean body dose (adjusted R² = 0.588) in predicting ALC decline. The EDRIC values of proton techniques (IMPT: 1.802 ± 0.602; SPArc: 1.404 ± 0.448) were significantly lower than those of photon techniques (IMRT: 3.193 ± 1.165; VMAT: 3.407 ± 1.340) (all P < 0.001). SPArc produced the lowest EDRIC, which was significantly better than IMPT (P < 0.001), while no significant difference was observed between IMRT and VMAT. SPArc also showed the best cardiopulmonary protection, with the lowest normal tissue complication probabilities for radiation pneumonitis (0.96%) and pericardial effusion (10.57%).</p><p><strong>Conclusion: </strong>In this exploratory study of early-stage ESCC patients, EDRIC was associated with RIL, explaining approximately 73% of the variation in ALC. EDRIC is highly dependent on radiotherapy technique, with proton therapy-especially SPArc-offering significant immune-sparing advantages. These findings warrant validation in larger prospective cohorts.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521016","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":"Ro 08-2750 increases radiation-induced cytotoxicity in DLBCL by dysregulating the DNA damage response.","authors":"Lasse Reichstein, Timo Habig, Kathrin A Gurke Brücksken, Mark Sicking, Eberhard Korsching, Gereon Poschmann, Michael Oertel, Georg Lenz, Stephan Hailfinger, Burkhard Greve, Fabian M Troschel, Hans Theodor Eich","doi":"10.1007/s00066-026-02571-8","DOIUrl":"https://doi.org/10.1007/s00066-026-02571-8","url":null,"abstract":"<p><strong>Purpose: </strong>Current research aims to increase treatment efficacy in diffuse large B‑cell lymphoma (DLBCL). Recently, Musashi‑2 (MSI-2) was identified as a negative prognostic marker and potential therapeutic target in DLBCL. Here, we evaluated the effect of the MSI‑2 inhibitor Ro 08-2750 in DLBCL cells.</p><p><strong>Methods: </strong>First, we established the effects of Ro 08-2750 on DLBCL in cell viability and clonogenicity assays. Changes in cell cycle and apoptosis were analyzed flow cytometrically. We then evaluated modifications in DLBCL treatment response when combining radiation treatment or chemotherapy with Ro 08-2750. Following confirmation of a Ro 08-2750-associated increase in radiation-induced DNA damage via a γH2AX assay, an immunoblot-based assay was used to detect changes in radiation-induced DNA damage repair protein activation. To understand Ro 08-2750-induced modifications in gene expression and protein abundance, we performed RT-qPCR, bulk mRNA-sequencing, western blotting, and quantitative mass spectrometry-based proteomic analyses.</p><p><strong>Results: </strong>Ro 08-2750 reduced cell viability and proliferation in DLBCL. Functionally, Ro 08-2750 induced cell cycle arrest in the S phase, where the DNA synthesis rate was attenuated. Additionally, apoptosis was increased. Ro 08-2750 also sensitized DLBCL cell lines to irradiation but not to chemotherapy, and it increased irradiation-induced DNA double-strand breaks. Transcriptome and proteome analyses showed changes in various tumor-associated signaling pathways, primarily associating Ro 08-2750 with compromised DNA repair, cell cycle, and cell division.</p><p><strong>Conclusion: </strong>We identified Ro 08-2750 as a radiosensitizer in DLBCL. Our results suggest that the combination of Ro 08-2750 with radiation therapy may enhance treatment efficacy.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472997","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":"Clinical and MRI factors influencing interobserver delineation variability of brain metastases before stereotactic radiotherapy.","authors":"Laurie Marchi, Julien Ognard, Alexis Perrot, Anne-Charlotte Roux, Stéphanie Rudzinska-Mistarz, François Lucia, Romuald Seizeur, Olivier Pradier, Gurvan Dissaux, Moncef Morjani, Brieg Dissaux, Vincent Bourbonne","doi":"10.1007/s00066-026-02574-5","DOIUrl":"10.1007/s00066-026-02574-5","url":null,"abstract":"<p><strong>Background: </strong>Innovations in systemic therapies have prolonged survival for many cancers, increasing the number of patients living with brain metastases. In stereotactic radiotherapy, steep dose gradients and small target margins mean that delineation differences may affect target coverage and the dose to adjacent normal brain. We aimed to identify lesion- and MRI-related factors associated with interobserver variability in brain metastasis gross tumor volume delineation.</p><p><strong>Methods: </strong>We retrospectively included 149 patients (354 metastases) treated with stereotactic radiotherapy at the University Hospital of Brest (2014-2022). Four radiology residents delineated each metastasis on pretreatment three-dimensional T1-weighted gadolinium-enhanced MRI after completing a structured training set of 40 brain metastases selected outside the study cohort (excluded from all analyses). Lesion characteristics (edema, hemorrhage, necrosis/cystic change, proximity to organs at risk, histology, and volume) and MRI acquisition parameters were collected. Interobserver agreement was quantified using the Dice similarity coefficient and the mean distance to agreement (MDA).</p><p><strong>Results: </strong>Medians and interquartile ranges (IQRs) for Dice and MDAs across metastases (pairwise values averaged per metastasis) were 0.85 (IQR 0.80-0.89) and 0.34 mm (IQR 0.29-0.44), respectively. Lesions with perilesional edema and a larger volume showed higher overlap agreement (Dice); however, MDA increased with lesion volume, consistent with greater absolute boundary deviations in larger lesions. Several distance-to-OAR variables showed significant univariable associations with agreement metrics; however, these findings were inconsistent across Dice and MDA and were not retained in multivariable analysis. Among MRI parameters, 3 T field strength was associated with a slightly higher agreement; no other parameters showed consistent associations in this exploratory analysis.</p><p><strong>Conclusion: </strong>Interobserver variability in brain metastasis delineation varies with lesion characteristics and selected MRI acquisition parameters. Standardized contouring guidance and MRI acquisition may reduce variability, supporting quality assurance and peer-review processes for stereotactic radiotherapy.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437935","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":"Timing matters: how mechanism-guided sequencing shapes the efficacy of radiotherapy-immunotherapy combinations : A systematic review.","authors":"Carlo Guglielmo Cattaneo, Enrico Pozzo, Giulia Panza, Giuditta Chiloiro, Angela Romano, Matteo Galetto, Matteo Nardini, Lorenzo Placidi, Maria Antonietta Gambacorta, Luca Boldrini","doi":"10.1007/s00066-026-02570-9","DOIUrl":"https://doi.org/10.1007/s00066-026-02570-9","url":null,"abstract":"<p><strong>Purpose: </strong>The combination of radiotherapy (RT) and immunotherapy has emerged as a central strategy in modern oncology, yet clinical outcomes remain highly variable. This variability is critically influenced by timing, including sequencing, interval, and temporal alignment with immune dynamics. We performed a systematic review to evaluate how mechanism-guided timing of RT relative to different immunotherapy classes shapes antitumor efficacy.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Embase, and Web of Science for studies published between 2009 and January 2026 evaluating RT-immunotherapy combinations with explicit timing or sequencing analysis. Preclinical and clinical studies reporting immune mechanisms, systemic immune responses, or efficacy outcomes were included. Data were extracted on immunotherapy class, RT regimen, sequencing strategy, and outcomes. Risk of bias was assessed using design-appropriate tools.</p><p><strong>Results: </strong>A total of 84 studies met inclusion criteria: 56 preclinical and 28 clinical, including four randomized controlled trials. Timing emerged as a critical biological determinant of synergy. Radiotherapy induced a temporally dynamic immune response encompassing immunogenic cell death, innate immune activation, T‑cell priming, and adaptive immune resistance. Optimal sequencing was mechanism-dependent: Cytotoxic T‑lymphocyte-associated protein 4 (CTLA-4) blockade was most effective before or concomitantly with RT; programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors performed best after RT, during peak T‑cell infiltration and checkpoint upregulation; co-stimulatory agonists showed optimal activity shortly after RT; and innate immune activators required immediate post-RT administration. Emerging evidence suggests circadian timing may further modulate efficacy.</p><p><strong>Conclusion: </strong>Timing is not a logistical variable but a central biological component of RT-immunotherapy combinations. A mechanism-guided temporal framework substantially influences immune responses and therapeutic outcomes, representing a low-cost, high-impact optimization strategy. Circadian considerations remain compelling but require validation in prospective trials.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424397","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":"Effects of intrafractional motion on targeting accuracy in frameless single-isocenter multi-target stereotactic radiosurgery.","authors":"Maximilian Grohmann, Cordula Petersen, Katharina Hintelmann, Manuel Todorovic","doi":"10.1007/s00066-026-02565-6","DOIUrl":"https://doi.org/10.1007/s00066-026-02565-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the impact of intrafractional motion on targeting accuracy in frameless single-isocenter multi-target stereotactic radiosurgery (SIMT) for brain metastases and examines the necessity of intrafractional six-degrees-of-freedom (6DoF) image-guided corrections.</p><p><strong>Methods: </strong>A total of 120 SIMT-SRS treatments and 294 couch kicks were analyzed using positioning data from an intrafractional stereoscopic X‑ray image-guidance system. Deviations exceeding clinical tolerance (0.5 mm/0.5°) triggered repositioning. Initial and final 6DoF shifts were compared. The dosimetric impact of simulated setup errors (0.5-1 mm, 0.5°-1°) was evaluated in 15 selected SIMT-SRS cases comprising 90 metastases. Target coverage and plan quality were assessed using D98%, conformity index, and gradient index. A multivariable regression model was applied to assess the influence of target volume and distance to the isocenter on target coverage.</p><p><strong>Results: </strong>Intrafractional motion exceeded tolerance thresholds after 66% of couch kicks, necessitating corrections. Translational and rotational errors decreased from 0.71 ± 0.38 mm and 0.58 ± 0.34° before correction to 0.33 ± 0.19 mm and 0.38 ± 0.18° after correction. Simulated setup errors progressively impaired target coverage and conformity. For 0.5 mm/0.5° errors, D98% decreased by 7.6% ± 2.5%, conformity index declined by 9.5% ± 4.9%, and gradient index increased by 1.2% ± 2.3%. At 1 mm/1°, D98% decreased by 17.3% ± 4.8%, conformity index declined by 26.6% ± 9.2%, and gradient index increased by 1.1% ± 2.6%. Smaller targets (≤ 0.4 cm³) were particularly sensitive. Multivariable analysis identified target volume as the primary predictor of coverage loss.</p><p><strong>Conclusion: </strong>Intrafractional motion in frameless SIMT-SRS frequently exceeds clinical tolerance thresholds after couch kicks and can compromise both target coverage and conformity. Even small setup errors degrade plan quality, particularly for small lesions, whereas changes in dose gradient are comparatively modest within the investigated range. Intrafractional 6DoF corrections are therefore essential to reduce geometric deviations and preserve treatment quality.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377033","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":"DEGRO practical guidelines: radiotherapy of breast cancer-regional nodal irradiation.","authors":"Kai Borm, David Krug, Stefanie Corradini, Christiane Matuschek, Leonard Christopher Schmeel, Gerd Fastner, Guido Henke, Montserrat Pazos, Rene Baumann, Vratislav Strnad, Wilfried Budach, Marc D Piroth, Nona Marciana Duma, Juliane Hörner-Rieber","doi":"10.1007/s00066-026-02554-9","DOIUrl":"10.1007/s00066-026-02554-9","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this work is to update the practical guidelines for adjuvant radiotherapy of the regional lymphatics in breast cancer, originally issued in 2014 by the Breast Cancer Expert Panel of the German Society of Radiation Oncology.</p><p><strong>Methods: </strong>A comprehensive literature review concerning regional nodal irradiation (RNI) was performed using the search terms \"breast cancer,\" \"radiotherapy,\" and \"regional node irradiation.\" Furthermore, data from recently published meta-analyses and international breast cancer society guidelines-providing new insights since 2014-served as the basis for defining evidence-based recommendations. This paper delineates the indications and dose-fractionation strategies for radiotherapy targeting the regional lymphatic pathways following breast cancer surgery.</p><p><strong>Results: </strong>The guideline was updated to reflect current evidence regarding radiotherapy of the lymphatic drainage system. The recommendations are categorized according to two primary objectives for RNI: (1) improving oncological outcomes; (2) enabling de-escalation of axillary surgery. The update distinguishes between clinical scenarios with and without neoadjuvant chemotherapy (NACT). Specifically, it addresses the increasingly relevant topic of treatment de-escalation following pathologic complete response (pCR) after NACT in initially node-positive patients.</p><p><strong>Conclusion: </strong>The updated guidelines address current developments and ongoing challenges in RNI. They provide clinically oriented recommendations for establishing indications in both the primary (upfront) surgery setting and following neoadjuvant therapy.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"692-707"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253205","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":"Shaping the future of radiation oncology education: results of a nationwide student survey from Germany.","authors":"Hendrik Dapper, Michael Oertel, Hilke Vorwerk, Sophia Drabke, Diana Steinmann, Emmanouil Fokas, Heinz Schmidberger, Nanna E Wielenberg, Matthias Mäurer, Philipp Linde","doi":"10.1007/s00066-025-02493-x","DOIUrl":"10.1007/s00066-025-02493-x","url":null,"abstract":"<p><strong>Background and purpose: </strong>Radiation oncology (RO) is a key component of cancer care and should be adequately represented in undergraduate medical education. In light of medical training reforms in German medical education and rising expectations for competency-based, practice-oriented learning, this nationwide survey explored medical students' perspectives on RO teaching and its future development.</p><p><strong>Materials and methods: </strong>A cross-sectional online survey was conducted from 2023 to 2025 across all 38 German medical faculties. Developed by the Working Group on Teaching of the German Society for Radiation Oncology (DEGRO), the 49-item questionnaire addressed curriculum structure, teaching quality, preferred formats, and interest in RO.</p><p><strong>Results: </strong>Among 1112 participants, 739 completed the survey. Although 96% viewed RO as being essential to cancer care, 62% felt it was underrepresented in the curriculum. Students called for more interdisciplinary and patient-centered teaching and showed high interest in digital and hybrid learning formats. Notably, 60.5% favored interdisciplinary oncology formats including RO, and nearly half expressed interest in elective RO courses.</p><p><strong>Conclusion: </strong>Despite its recognized importance, RO remains inconsistently represented in medical education. Embedding RO in interdisciplinary oncology modules and expanding digital, longitudinal, and flexible teaching formats could enhance its visibility and relevance. Given students' strong interest in more in-depth exposure, optional and elective formats should be further developed to meet modern educational expectations.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"713-721"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912858","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":"Stereotactic heart ablative radiotherapy (SHARP): a prospective multicentric phase II trial.","authors":"Aurélie Gaasch, Sebastian N Marschner, Philipp Hoegen-Saßmannshausen, Elisabetta Sandrini, Juliane Hörner-Rieber, Nicolaus Andratschke, Panagiotis Balermpas, Luca Boldrini, Angela Romano, Michael Reiner, Maximilian Niyazi, Lars Lindner, Ludwig Weckbach, Nicola Fink, Christian Hagl, Claus Belka, Stefanie Corradini","doi":"10.1007/s00066-026-02504-5","DOIUrl":"10.1007/s00066-026-02504-5","url":null,"abstract":"<p><strong>Background: </strong>Cardiac tumors are exceedingly rare with metastatic involvement representing the most frequent form of malignancy within the heart. In patients presenting with inoperable primary or recurrent malignant cardiac sarcomas or cardiac/epicardial/pericardial metastases, stereotactic body radiotherapy (SBRT) serves as an alternative local treatment to surgery or may, in some cases, constitute the sole viable local treatment modality. To date, there are only case reports or small retrospective studies assessing SBRT dose and toxicity for cardiac SBRT. The goal of this prospective multicentric observational study is to systematically evaluate the feasibility, toxicity and outcome of magnetic resonance-guided stereotactic body radiation therapy (MRgSBRT) in the management of primary and secondary cardiac malignancies.</p><p><strong>Methods: </strong>The treatment is performed using MR-guided SBRT in five fractions on non-consecutive days (6-8 Gy per fraction prescribed to the 80% isodose). Four study centers participate in this prospective phase II trial (Heidelberg, Munich, Rome, Zurich). Eligible patients who consent to participate in the study will undergo treatment as indicated and approved by an interdisciplinary tumor board. Primary objective is to assess the feasibility and safety of online adaptive MRgSBRT; secondary endpoints are local control and survival outcome, acute and late toxicity, patient-reported outcome as well as technical feasibility of treatment.</p><p><strong>Discussion: </strong>The findings from this study may serve as a foundation for the future integration of cardiac SBRT into clinical practice guidelines for the management of cardiac malignancies.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"744-750"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087112","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":"Comparative analysis of different modalities of radiotherapy in vestibular schwannoma: tumor control, symptom evolution, and toxicity profiles.","authors":"Phillipp Lishewski, Maike Fischer, Kerem Tuna Tas, Fatima Frosan Sheikhzadeh, Edgar Smalec, Linda Agolli, Christopher Nimsky, André Kemmling, Daniel Habermehl, Klemens Zink, Ahmed Gawish, Sebastian Adeberg","doi":"10.1007/s00066-026-02516-1","DOIUrl":"10.1007/s00066-026-02516-1","url":null,"abstract":"<p><strong>Background: </strong>Stereotactic radiotherapy (SRT) is a standard treatment for vestibular schwannoma (VS). Long-term comparative data on single-fraction radiosurgery (SRS) versus normofractionated SRT (NFSRT) are limited.</p><p><strong>Methods: </strong>We retrospectively analyzed 175 VS patients treated between 1998 and 2023 (SRS n = 69; NFSRT n = 106; median age 61 years; median follow-up 46 months). Tumor control was evaluated with Kaplan-Meier and Cox regression. Group differences were tested with Mann-Whitney U and chi-square/Fisher's exact tests. Symptom changes were assessed with McNemar tests, and binary logistic regression identified predictors of acute and late toxicity.</p><p><strong>Results: </strong>Overall, in-field PFS was 94.3% and out-field was PFS was 99.4%. All 10 recurrences (median 58.5 months) occurred in NFSRT patients treated with 55.8-56 Gy. Higher total dose predicted recurrence (HR = 2.97; p = 0.003). At baseline, 97.1% reported symptoms (hearing loss 86.9%, vertigo 48.0%, tinnitus 42.3%). After therapy, symptoms remained stable, except the incidence of headache, which increased from 14.3% to 22.3% (p = 0.02). Early toxicities were more common after NFSRT, including headache (OR = 4.05; p = 0.01), fatigue (OR = 5.12; p = 0.01), and alopecia (OR = 19.9; p = 0.04), but had resolved by late follow-up. Age and prior surgery predicted vertigo patterns over time. Radionecrosis was rare (0.6%).</p><p><strong>Conclusion: </strong>Both SRS and NFSRT achieve excellent long-term tumor control with low severe toxicity. For NFSRT, normofractionated doses above 55 Gy did not improve efficacy and may increase the recurrence risk, supporting moderate-dose regimens (50-54 Gy). Symptom stabilization confirms the safety of SRT, though headache and vertigo remain relevant long-term issues. Careful dose selection, patient counseling, and rehabilitation are essential to optimize outcomes.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"751-759"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147532674","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":"Bridging gaps in care: medical student home visits and their influence on radiation oncology patients.","authors":"Jana Borgerding, Katrin Liethmann, David Krug, Christian Schulz, Jürgen Dunst, Amke Caliebe, Claudia Schmalz","doi":"10.1007/s00066-026-02508-1","DOIUrl":"10.1007/s00066-026-02508-1","url":null,"abstract":"<p><strong>Purpose: </strong>Patient care in radiation oncology is challenging. Interface problems can arise, particularly when transitioning from the inpatient to home environment. Inpatients' perception of safety regarding the upcoming discharge and their satisfaction with care were addressed in the project.</p><p><strong>Methods: </strong>\"Bridging the gaps\" was an optional course for medical students in their 5th year. The study consisted of two arms-one with a home visit by medical students and the other without such a visit. Before discharge, inpatient radiation oncology patients were offered a home visit by medical students. A survey was conducted before (time point 1) and 3-5 days after discharge (time point 2) using questionnaires concerning satisfaction with care, current health status, and perception of safety. Outcome changes between time points 1 and 2 in both groups (with vs. without home visit) were compared.</p><p><strong>Results: </strong>A total of 60 patients were interviewed. Patients which received a home visit expressed improved perception of safety after discharge, whereas patients without a home visit showed decreased perception of safety (p = 0.024 for group-difference). Both groups showed a high level of satisfaction with care, which varied between the time points. In patients without a home visit, satisfaction decreased significantly after discharge, whereas satisfaction slightly increased in patients with a home visit (p = 0.001 for group-difference).</p><p><strong>Conclusion: </strong>Radiation oncology patients may benefit from home visits by increasing their perception of safety. Continuation and expansion of the project could strengthen the role of radiation oncology in the cross-sectoral care system.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"722-733"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132808","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}