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Effect of continuous positive airway pressure administration during lung stereotactic ablative radiotherapy: a  comparative planning study
In this study, we evaluated the effect of CPAP on lung volume, tumour motion amplitude and baseline shift, as well as the dosimetric impact of the strategy.MethodsTwenty patients with lung tumours referred for SABR underwent 4D-computed tomography (CT) scans with and without CPAP (CPAP/noCPAP) at two timepoints (T0/T1). First, CPAP and noCPAP scans were compared for lung volume, tumour motion amplitude, and baseline shift. Next, CPAP and noCPAP treatment plans were computed and compared for lung dose parameters (mean lung dose (MLD), lung volume receiving 20 Gy (V20Gy), 13 Gy (V13Gy), and 5 Gy (V5Gy)) and mean heart dose (...
Source: Strahlentherapie und Onkologie - February 15, 2018 Category: Cancer & Oncology Source Type: research

Occurrence of pneumonitis following radiotherapy of breast cancer – A prospective study
AbstractAimof this study is to determine the temporal resolution of therapy-induced pneumonitis, and to assess promoting factors in adjuvant treated patients with unilateral mammacarcinoma.Patients and methodsA  total of 100 post-surgery patients were recruited. The cohort was treated by 2 field radiotherapy (2FRT; breast and chest wall,N = 75), 3 field radiotherapy (3FRT; + supraclavicular lymphatic region,N = 8), or with 4 field radiotherapy (4FRT; + parasternal lymphatic region,N = 17). Ninety-one patients received various systemic treatments prior to irradiation. Foll...
Source: Strahlentherapie und Onkologie - February 15, 2018 Category: Cancer & Oncology Source Type: research

Response rates and recurrence patterns after low-dose radiotherapy with 4  Gy in patients with low-grade lymphomas
ConclusionPrimary LDRT is an effective treatment with high ORR and long-lasting remissions in a  subset of patients with low-grade lymphoma, and may therefore be a curative treatment option for patients with low tumor burden. LDRT with the CD20 antibody obinutuzumab will soon be tested in a prospective multicenter trial. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - February 15, 2018 Category: Cancer & Oncology Source Type: research

Under-reported dosimetry errors due to interplay effects during VMAT dose delivery in extreme hypofractionated stereotactic radiotherapy
ConclusionThis study is further proof of considerable influence of interplay effects on VMAT dose delivery in stereotactic radiotherapy. For selected conditions of an exemplary scenario, interplay effects and related motion-induced target underdosage primarily occurred in tumour motion pattern with increased motion variability and VMAT plan delivery using complex MLC dose modulation. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - February 15, 2018 Category: Cancer & Oncology Source Type: research

Nachruf f ür Prof. Dr. med. Dr. hc. Wilhelm Oelßner, langjähriges Ehrenmitglied der DEGRO
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - February 15, 2018 Category: Cancer & Oncology Source Type: research

Semantic imaging features predict disease progression and survival in glioblastoma multiforme patients
ConclusionsWe demonstrated a  predictive value of several qualitative imaging features for progression and survival. The performance of prognostic models was increased by combining clinical, pathological, and imaging features. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - February 13, 2018 Category: Cancer & Oncology Source Type: research

Direct dose correlation of MRI morphologic alterations of healthy liver tissue after robotic liver SBRT
ConclusionsEarly post-treatment changes in healthy liver tissue after robotic SBRT could spatially be correlated to respective isodoses. Median nominal doses of 10.1 –11.3 Gy per fraction (EQD2 79–97 Gy3) induce characteristic morphologic alterations surrounding the lesions, potentially allowing for dosimetric in-vivo accuracy assessments. Comparison to other techniques and investigations of the short- and long-term clinical impact require further research. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - February 5, 2018 Category: Cancer & Oncology Source Type: research

Kombination aus perkutaner Strahlentherapie, Brachytherapie und Androgendeprivation gleichwertige Alternative zur radikalen Prostatektomie beim Prostatakarzinom
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - February 5, 2018 Category: Cancer & Oncology Source Type: research

Komplikationen statt Überlebensvorteil und lokale Rezidivfreiheit nach früher radikaler Zystektomie bei muskelinvasivem Harnblasenkarzinom im Vergleich zur multimodalen Erhaltungstherapie
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - February 2, 2018 Category: Cancer & Oncology Source Type: research

Nivolumab f ür das vorbehandelte metastasierte Analkarzinom
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - February 1, 2018 Category: Cancer & Oncology Source Type: research

Kommentar zu „T1–2 glottic cancer treated with radiotherapy and/or surgery“
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 31, 2018 Category: Cancer & Oncology Source Type: research

Individualization of post-mastectomy radiotherapy and regional nodal irradiation based on treatment response after neoadjuvant chemotherapy for breast cancer
ConclusionsThere is a  considerable lack of evidence regarding the role of adjuvant radiotherapy and its individualization based on treatment response after NACT. Results of prospective randomized trials such as NSABP B‑51/RTOG 1304 and Alliance A11202 are eagerly awaited. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 30, 2018 Category: Cancer & Oncology Source Type: research

Use of androgen deprivation and salvage radiation therapy for patients with prostate cancer and biochemical recurrence after prostatectomy
ConclusionsADT combined with SRT appears to improve OS in patients with a  PSA level before SRT of ≥0.7 ng/mL. In patients without persistent PSA after prostatectomy and PSA levels of
Source: Strahlentherapie und Onkologie - January 30, 2018 Category: Cancer & Oncology Source Type: research

Durvalumab verbessert die Prognose beim lokal fortgeschrittenen nicht-kleinzelligen Bronchialkarzinom nach definitiver Radiochemotherapie
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 26, 2018 Category: Cancer & Oncology Source Type: research

Patient positioning in head and neck cancer
ConclusionsThe calculated safety margins differ between anatomic regions. Repetitive and frequent image control of patient positioning is necessary that, however, possibly may be focussed on a  limited region. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 25, 2018 Category: Cancer & Oncology Source Type: research

Einfluss der prophylaktischen Ganzhirnbestrahlung auf das Gesamt überleben beim fortgeschrittenen kleinzelligen Bronchialkarzinom
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 25, 2018 Category: Cancer & Oncology Source Type: research

Retrospective inconsistent analysis cannot validate safety of a  treatment strategy
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 25, 2018 Category: Cancer & Oncology Source Type: research

Repeat reirradiation of the spinal cord: multi-national expert treatment recommendations
ConclusionsThe increasing body of literature about bone metastases and spinal cord reirradiation has encouraged some expert RO to offer palliative reirradiation with cumulative cord doses above 75  Gy EQD2; however, no consensus was achieved. Strategies for harmonization of clinical practice and development of evidence-based dose constraints are discussed. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 23, 2018 Category: Cancer & Oncology Source Type: research

Dose optimization of total or partial skin electron irradiation by thermoluminescent dosimetry
ConclusionsThermoluminescent dosimetry allows an individual dose optimization in TSEI and PSEI to enable a  reliable adjustment of the MUs to obtain the prescription dose. Especially in PSEI in vivo dosimetry is of fundamental importance. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 19, 2018 Category: Cancer & Oncology Source Type: research

Quality of training in radiation oncology in Germany: where do we stand?
ConclusionRadiation oncology remains an attractive and versatile specialty with favorable working conditions. Continuing surveys in future years will be a  valuable measuring tool to set further priorities in order to preserve and improve quality of training. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 18, 2018 Category: Cancer & Oncology Source Type: research

Neoadjuvant chemoradiation for esophageal cancer
ConclusionOutcomes of our cohort were comparable to other series using similar treatments. Surgery significantly improved locoregional control but not survival. Response based on FDG-PET/CT predicted survival and might be used for treatment stratification. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 18, 2018 Category: Cancer & Oncology Source Type: research

Does the interval from tumour surgery to radiotherapy influence survival in paediatric high grade glioma?
ConclusionsISRT did not influence survival in pHGG. In view of upcoming targeted treatment options in pHGG the present data suggest that it is safe to perform molecular analyses within a  4-week timeframe before radiotherapy. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 18, 2018 Category: Cancer & Oncology Source Type: research

Improved effectiveness of stereotactic radiosurgery in large brain metastases by individualized isotoxic dose prescription: an in silico study
ConclusionsUsing three-fraction or five-fraction IDP the predicted TCP can be increased safely to 55 and 68%, respectively, in large BM with a  diameter of 4 cm with a low risk of RN. Using IDP, the therapeutic ratio of SRS in large BM can be increased compared to current SRS dose prescription. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 18, 2018 Category: Cancer & Oncology Source Type: research

Prospective feasibility analysis of a  novel off-line approach for MR-guided radiotherapy
ConclusionThis trial demonstrated for the first time the feasibility and patient compliance of a  shuttle-based off-line approach to MRgRT of pelvic malignancies. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 18, 2018 Category: Cancer & Oncology Source Type: research

Patient-reported symptoms before palliative radiotherapy predict survival differences
ConclusionsStronger pain while not moving and reduced appetite (below/above median) predicted significantly shorter survival. Development of new prognostic scores should include patient-reported symptoms and other innovative parameters because they were more important than primary tumor type, age and other traditional baseline parameters. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 17, 2018 Category: Cancer & Oncology Source Type: research

Prognostic implications of the co-detection of the urokinase plasminogen activator system and osteopontin in patients with non-small-cell lung cancer undergoing radiotherapy and correlation with gross tumor volume
AbstractBackgroundThe urokinase plasminogen activator system (uPA, uPAR, PAI ‑1) is upregulated in cancer and high plasma levels are associated with poor prognosis. Their interaction with hypoxia-related osteopontin (OPN) which is also overexpressed in malignant tumors suggests potential clinical relevance. However, the prognostic role of the uPA system in the radiotherapy (RT) of non-small-cell lung cancer (NSCLC), particularly in combination with OPN, has not been investigated so far.MethodsuPA, uPAR, PAI ‑1 and OPN plasma levels of 81 patients with locally advanced or metastasized NSCLC were prospectively analy...
Source: Strahlentherapie und Onkologie - January 16, 2018 Category: Cancer & Oncology Source Type: research

The role of albumin –bilirubin grade and inflammation-based index in patients with hepatocellular carcinoma treated with stereotactic body radiotherapy
ConclusionsIn this analysis, a  higher ALBI grade as well as a higher CP were predictors of higher incidence of toxicity, whereas a lower IBI during treatment correlated with a better OS. These results should be further evaluated in prospective studies. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 10, 2018 Category: Cancer & Oncology Source Type: research

A randomized phase  III study between sequential versus simultaneous integrated boost intensity-modulated radiation therapy in nasopharyngeal carcinoma
ConclusionSEQ and SIB provide excellent survival outcomes with few late toxicities. According to our study, SIB with a  satisfactory dose–volume constraint to nearby critical organs is the technique of choice for NPC treatment due to its convenience. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 4, 2018 Category: Cancer & Oncology Source Type: research

Verbessertes Überleben beim fortgeschrittenen oder metastasierten Prostatakarzinom durch zusätzliches Abirateron zur initialen Androgendeprivation
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - January 4, 2018 Category: Cancer & Oncology Source Type: research

Das neue Strahlenschutzgesetz – Auswirkungen auf die radioonkologische Forschung in Deutschland
ZusammenfassungVor dem Hintergrund der Europ äischen Richtlinie 2013/59/Euratom hat der Bundesgesetzgeber das neue Strahlenschutzgesetz erlassen. Dieses wird ab dem 01.01.2019 die Anwendung ionisierender Strahlung in der Heilbehandlung und der medizinischen Forschung regeln. Während die grundsätzliche Aufteilung zwischen Heilbehandlung und Forschung beibehalten wird, offenbaren sich im Detail mitunter gravierende Unterschiede zum bestehenden Recht. Die Neuregelungen für den Bereich der radioonkologischen Forschung werden in diesem Beitrag beleuchtet. Der Fokus liegt dabei auf der Darstellung der neuen F...
Source: Strahlentherapie und Onkologie - December 22, 2017 Category: Cancer & Oncology Source Type: research

Automated volumetric modulated arc therapy planning for whole pelvic prostate radiotherapy
ConclusionAutomated VMAT planning for complex WPRT dose distributions is feasible and creates treatment plans that are generally dosimetrically superior to manually optimized plans. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - December 21, 2017 Category: Cancer & Oncology Source Type: research

Langzeitergebnisse der adjuvanten im Vergleich zur Early-Salvage-Bestrahlung beim pT3N0-Prostatakarzinom nach radikaler Prostatektomie
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - December 20, 2017 Category: Cancer & Oncology Source Type: research

Fr ühe Mitbetreuung nichtheilbarer Krebspatienten durch Palliativteams bessert die Lebensqualität und fördert Gespräche über Versorgungswünsche am Lebensende
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - December 20, 2017 Category: Cancer & Oncology Source Type: research

Reirradiation  + hyperthermia for recurrent breast cancer en cuirasse
ConclusionReRT+HT provides sustainable palliative tumor control, despite refractory, extensive tumor growth. Compared to currently available systemic treatment options, reRT+HT is more effective with less toxicity. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - December 20, 2017 Category: Cancer & Oncology Source Type: research

Welche Patienten mit lokalisiertem Prostatakarzinom profitieren von welchem lokalen Vorgehen und was bedeutet „profitieren“ beim Prostatakarzinom?
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - December 20, 2017 Category: Cancer & Oncology Source Type: research

Salvage radiotherapy in prostate cancer patients with biochemical relapse after radical prostatectomy
AbstractBackgroundIn patients with prostate cancer (PCa) and biochemical progression (BP) after radical prostatectomy (RP), salvage radiotherapy (sRT) improves prostate cancer-specific survival (PCSS), but this evidence is based only on retrospective data.Patients and methodsIn addition to our previous study of 151  patients with PCa and BP after RP, we performed univariate analyses of prostate-specific antigen (PSA) kinetics during sRT. In 11 patients with BP or initiation of hormonal treatment (HT) within 180 days after sRT, risk factors were assessed using Mann–Whitney U tests. PSA doubling tim...
Source: Strahlentherapie und Onkologie - December 18, 2017 Category: Cancer & Oncology Source Type: research

Real-time beam monitoring for error detection in IMRT plans and impact on dose-volume histograms
ConclusionThe detector is capable of detecting small delivery errors in MU and leaf positions, and is thus a  highly sensitive dose monitoring device for S&S IMRT for clinical practice. The results of this study indicate a  good correlation of detector signal with DVH metrics; therefore, clinical action levels can be defined based on the presented data. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - December 18, 2017 Category: Cancer & Oncology Source Type: research

Thank you to all reviewers of Strahlentherapie und Onkologie 2017
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - December 12, 2017 Category: Cancer & Oncology Source Type: research

ÖGRO survey on radiotherapy capacity in Austria
ConclusionThis ÖGRO survey revealed major regional differences in radiooncological capacity. Considering epidemiological developments, an aggravation of the situation can be expected shortly. This analysis serves as a basis for improved public regional health care planning. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - December 8, 2017 Category: Cancer & Oncology Source Type: research

Oligometastases in prostate cancer
ConclusionsPreliminary results of this study show high metabolic response rates of PSMA PET-positive metastatic lesions after hypofractionated radiotherapy in follow-up PSMA PET with promising local control rates. An interval of several months may be required to fully estimate the efficacy of radiotherapy in control PSMA PET. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - November 27, 2017 Category: Cancer & Oncology Source Type: research

Long-term outcomes in patients younger than 60  years of age treated with brachytherapy for prostate cancer
ConclusionsLDR brachytherapy provides patients younger than 60  years of age with low and intermediate-risk prostate cancer excellent outcomes and has a low risk of significant long-term GU or gastrointestinal morbidity. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - November 21, 2017 Category: Cancer & Oncology Source Type: research

Postoperative Strahlentherapie beim Prostatakarzinom
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - November 21, 2017 Category: Cancer & Oncology Source Type: research

Radiotherapy for extramedullary leukaemic manifestation (Chloroma)
ConclusionsLow-dose RT ( ≤26 Gy) achieves good local control compared to high-dose regimes. Bone marrow state during RT and ECOG score during RT may play a crucial role, influencing both DOLC and OS. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - November 16, 2017 Category: Cancer & Oncology Source Type: research

Medulloblastoma in adults
ConclusionsThe combined modality treatment showed a  good outcome in adults with medulloblastoma. Treatment time was revealed to be prognostic and should be kept as short as possible. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - November 16, 2017 Category: Cancer & Oncology Source Type: research

Konventionelle oder akzeleriert-hyperfraktionierte simultane Radiochemotherapie beim kleinzelligen Lungenkarzinom im Stadium „limited disease“?
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - November 15, 2017 Category: Cancer & Oncology Source Type: research

Patterns of relapse as determined by 68 Ga-PSMA ligand PET/CT after radical prostatectomy
ConclusionOur results suggest that in patients with biochemical recurrence who did not receive early sRT, a68Ga-PSMA ligand PET/CT for restaging of disease allows for tailoring and individualizing treatment. Particularly in patients with PSA levels above 1.0  ng/mL, a68Ga-PSMA ligand PET/CT should be performed for therapy planning, since patients often have metastases not confined to the pelvis. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - November 13, 2017 Category: Cancer & Oncology Source Type: research

Intensified preoperative chemoradiation by adding oxaliplatin in locally advanced, primary operable (cT3NxM0) rectal cancer
ConclusionLNneg after preoperative treatment for LARC significantly influences patient survival. A  radical surgical approach for recurrent LARC (locoregional, distant) should be contemplated when possible as we were able to clearly demonstrate its importance and efficacy. (Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - November 10, 2017 Category: Cancer & Oncology Source Type: research

Morbidit ät und Letalität durch Meningeome nach kranialer Strahlentherapie
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - November 10, 2017 Category: Cancer & Oncology Source Type: research

Zum Tod unseres Ehrenmitglieds, Prof. Seymour Levitt MD
(Source: Strahlentherapie und Onkologie)
Source: Strahlentherapie und Onkologie - November 10, 2017 Category: Cancer & Oncology Source Type: research

Analysis of primary tumor metabolic volume during chemoradiotherapy in locally advanced non-small cell lung cancer
This study evaluated the role of primary tumor metabolic volume (PT-MV) changes on PET/CT before, during, and after chemoradiotherapy (CRT).MethodsA total of 65 patients with non-small-cell lung cancer (NSCLC) UICC stage IIIA/B (TNM 7th Edition) were treated with definitive chemoradiotherapy (sequential or concurrent setting). PET/CT was acquired before the start, at the end of the third week, and 6  weeks following CRT.ResultsMedian overall survival (OS) for the entire cohort was 16  months (95% confidence interval [CI]: 12–20). In all, 60 (92.3%) patients were eligible for pre-treatment (pre-PT-MV), 28 (4...
Source: Strahlentherapie und Onkologie - November 7, 2017 Category: Cancer & Oncology Source Type: research