TY - JOUR AB - PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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. AU - Leiss, S.M.* AU - Hou, H.X.* AU - Pigorsch, S.* AU - Borm, K.* AU - Peeken, J.C.* AU - Schneider, A.* AU - Combs, S.E. AU - Dinkel, A.* AU - Bernhardt, D.* C1 - 73092 C2 - 56910 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 723-731 TI - Analysis of radiation oncology integration within general practitioners' daily patient care: A cross-sectional survey in Germany. JO - Strahlenther. Onkol. VL - 201 IS - 7 PB - Springer Heidelberg PY - 2025 SN - 0179-7158 ER - TY - JOUR AB - PURPOSE: The aim of this review is to give an overview of the results of prospective and retrospective studies using allogenic reconstruction and postmastectomy radiotherapy (PMRT) in breast cancer and to make recommendations regarding this interdisciplinary approach. MATERIALS AND METHODS: A PubMed search was conducted to extract relevant articles from 2000 to 2024. The search was performed using the following terms: (breast cancer) AND (reconstruction OR implant OR expander) AND (radiotherapy OR radiation). Data from the literature on allogenic breast reconstruction and radiation are presented and discussed in relation to toxicity and cosmesis. CONCLUSION AND RECOMMENDATIONS: Breast reconstruction is also feasible if PMRT is necessary. Patients need to be informed about the relevant risk of capsular fibrosis and implant failure. A planned reconstruction is no reason to forgo PMRT nor is an indication for PMRT a reason to forego implant-based breast reconstruction if desired by the patient. It is important to provide detailed information here to enable shared decision-making. There is still no clear consensus regarding implant-based reconstruction (IBR) and PMRT. However, in clinical practice, both a one-stage (immediate "implant-direct" IBR) procedure with PMRT up to the final implant and a two-stage (immediate-delayed IBR) procedure with PMRT up to the tissue expander (TE) and later exchange of the TE are used; both approaches have their specific advantages and disadvantages. Depending on patient-specific factors and the surgeon's experience and estimates, both IBR procedures are also possible in combination with PMRT. When using a TE/implant approach, completing skin stretching by adequately filling the expander before PMRT may be favorable. This approach is particularly practical when adjuvant chemotherapy is planned but may lead to postponement of radiotherapy when primary systemic therapy is given. According to the latest data, moderate hypofractionation also appears to be safe in the context of the IBR approach. It is important to have a closely coordinated interdisciplinary approach and to fully inform patients about the increased rate of potential side effects. AU - Piroth, M.D.* AU - Krug, D.* AU - Baumann, R.* AU - Strnad, V.* AU - Borm, K.* AU - Combs, S.E. AU - Corradini, S.* AU - Duma, M.N.* AU - Dunst, J.* AU - Fastner, G.* AU - Feyer, P.* AU - Fietkau, R.* AU - Harms, W.* AU - Hehr, T.* AU - Hörner-Rieber, J.* AU - Matuschek, C.* AU - Schmeel, C.* AU - Budach, W.* C1 - 72985 C2 - 56884 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 353-367 TI - Implant-based reconstruction and adjuvant radiotherapy in breast cancer patients-current status and DEGRO recommendations. JO - Strahlenther. Onkol. VL - 201 IS - 4 PB - Springer Heidelberg PY - 2025 SN - 0179-7158 ER - TY - JOUR AB - PURPOSE: There is an urgent need to recruit and retain young professionals in radiation oncology and radiation research as the healthcare system faces major challenges. Our study investigated the experiences and needs of young professionals in this field, focusing on the impact of unpaid care work and gender-related issues. METHODS: A web-based survey was created and distributed over a six-week period, featuring one general questionnaire along with three occupation-specific versions tailored for physicians, biologists, and medical physicists involved in radiation oncology and research. RESULTS: Most participants with care responsibilities have temporary contracts, especially female physicians and biologists, while female medical physicists are more likely to hold permanent positions. Research is often conducted outside regular hours, with limited cover arrangements and part-time options varying by field. Key career risks include economic pressure, work-life balance, and uncertain contracts, with employees with care duties feeling less supported overall. In addition, men seem to be more involved in care work and thus face unique challenges, such as insufficient career support and fears of poor future perspective. The study emphasizes the need for strategies to address relevant issues, such as flexible working arrangements, better mentoring support, and clear substitution policies that can ensure that young professionals can balance caring responsibilities with work and career demands. CONCLUSION: Addressing these challenges is critical for sustaining a diverse and qualified workforce in radiation oncology and radiation research, ensuring excellence in patient care and scientific progress. AU - Trommer, M.* AU - Grohmann, M.* AU - Fabian, A.* AU - Ehret, F.* AU - Hess, J. AU - Rückert, M.* AU - Matschke, J.B.* AU - Stefanowicz, S.* AU - Rühle, A.* AU - Ferdinandus, S.* AU - Merten, R.* AU - Besserer, A.* AU - Schmidt, L.* AU - Sperk, E.* AU - Depardon, A.* AU - Putz, F.* AU - Petersen, C.* AU - Haderlein, M.* AU - Schröder, A.* AU - Weissmann, T.* AU - Deloch, L.* C1 - 74805 C2 - 57599 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany TI - Balancing barriers: Family, career, and gender equality in radiation oncology and radiation research-An interdisciplinary prospective survey among the young workforce. JO - Strahlenther. Onkol. PB - Springer Heidelberg PY - 2025 SN - 0179-7158 ER - TY - JOUR AB - BACKGROUND: Progression-free (PFS) and overall survival (OS) in UICC stage III non-small cell lung cancer (NSCLC) after definitive concurrent chemoradiotherapy (CRT) can be increased with consolidating immunotherapy. Recent studies have shown a strong predictive value of gross tumor volume (GTV) changes during CRT on OS. The TORCH trial investigated the prognostic impact of GTV changes during CRT as a predictor for a response to immunotherapy. METHODS: This retrospective non-interventional observational multicenter trial included n = 203 patients from 10 German university centers for radiation oncology with confirmed inoperable NSCLC in UICC stage III A-C. Patients had received CRT between 2015 and 2023 as a curative-intent treatment approach. Patient and tumor characteristics were collected anonymously via electronic case report forms. Initial GTVs before CRT (initial planning CT, GTV1) and at 40-50 Gy (re-planning CT for radiation boost, GTV2) were delineated. Absolute and relative GTV changes before/during CRT were correlated with OS to predict the response to CRT with sequential immunotherapy. Hazard ratios (HR) of survival analyses were estimated using adjusted Cox regression models. RESULTS: The mean GTV1 before radiation therapy (RT) was 145.29 ml with the 25th, 50th, and 75th percentiles being 61.36 ml, 145.29 ml, and 204.93 ml, respectively. Before initiation of the radiation boost, the mean GTV2 was 99.58 ml, with the 25th, 50th, and 75th percentiles at 32.93 ml, 70.45 ml, and 126.85 ml. The HR for the impact of GTV1 on survival was 0.99 per ml (95% confidence interval [CI] 0.99-1.00; p = 0.49). For the absolute volume change between GTV1 and GTV2, the HR was 1.004 per ml (95% CI 0.997-1.011; p = 0.26). In a subgroup analysis of patients who were treated with durvalumab, absolute volume changes between GTV1 and GTV2 were associated with longer OS (HR = 0.955 per ml; 95% CI 0.916-0.996; p = 0.03). Overall, durvalumab treatment was positively associated with OS, demonstrating an HR of 0.454 (95% CI 0.209-0.990; p = 0.047). CONCLUSION: Pretreatment GTV and absolute GTV volume changes did not significantly correlate with OS. However, the absolute volume change between the pretreatment and replanning GTV was associated with longer OS in patients treated with durvalumab. Histological subtype, grading, UICC stage, age at onset, pulmonary comorbidities, and smoking status had no significant association with OS. Durvalumab treatment was associated with improved OS. AU - Trommer, S.* AU - Müller, J.A.* AU - Oertel, M.* AU - Ehret, F.* AU - Roohani, S.* AU - Ha, H.M.* AU - Ha, Q.N.* AU - Hering, K.* AU - Nägler, F.* AU - Lange, T.* AU - Maurer, M.* AU - Weissmann, T.* AU - Putz, F.* AU - Trommer, M.* AU - Baues, C.* AU - Dobiasch, S. AU - Waltenberger, M.* AU - Skripcak, T.* AU - Vordermark, D.* AU - Medenwald, D.* C1 - 73572 C2 - 57098 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany TI - Tumor volume change at radiation boost planning to estimate the response to chemoradiotherapy in stage III unresectable NSCLC (TORCH): A multicenter retrospective observational study. JO - Strahlenther. Onkol. PB - Springer Heidelberg PY - 2025 SN - 0179-7158 ER - TY - JOUR AB - BACKGROUND: Artificial intelligence (AI)-based autocontouring software has the potential to revolutionize radiotherapy planning. In recent years, several AI-based autocontouring solutions with many advantages have emerged; however, their clinical use raises several challenges related to implementation, quality assurance, validation, and training. The aim of this study was to investigate the current use of AI-based autocontouring software and the associated expectations and hopes of radiation oncologists and medical physicists in German-speaking countries. METHODS: A digital survey consisting of 24 questions including single-choice, multiple-choice, free-response, and five-point Likert scale rankings was conducted using the online tool umfrageonline.com (enuvo GmbH, Pfäffikon SZ, Switzerland). RESULTS: A total of 163 participants completed the survey, with approximately two thirds reporting use of AI-based autocontouring software in routine clinical practice. Of the users, 92% found the software helpful in clinical practice. More than 90% reported using AI solutions to contour organs at risk (OARs) in the brain, head and neck, thorax, abdomen, and pelvis. The majority (88.8%) reported time savings in OAR delineation, with approximately 41% estimating savings of 11-20 min per case. However, nearly half of the respondents expressed concern about the potential degradation of resident training in sectional anatomy understanding. Of respondents, 60% would welcome guidelines for implementation and use of AI-based contouring aids from their respective radiation oncology societies. Respondents' free-text comments emphasized the need for careful monitoring and postprocessing of AI-delivered autocontours as well as concerns about overreliance on AI and its impact on the development of young physicians' contouring and planning skills. CONCLUSION: Artificial intelligence-based autocontouring software shows promise for integration into radiation oncology workflows, with respondents recognizing its potential for time saving and standardization. However, successful implementation will require ongoing education and curriculum adaptation to ensure AI enhances, rather than replaces, clinical expertise. AU - Vorbach, S.M.* AU - Putz, F.* AU - Ganswindt, U.* AU - Janssen, S.* AU - Grohmann, M.* AU - Knippen, S.* AU - Heinemann, F.* AU - Shafie, R.A.E.* AU - Peeken, J.C. C1 - 74222 C2 - 57402 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany TI - Contouring in transition: Perceptions of AI-based autocontouring by radiation oncologists and medical physicists in German-speaking countries. JO - Strahlenther. Onkol. PB - Springer Heidelberg PY - 2025 SN - 0179-7158 ER - TY - JOUR AB - PURPOSE: Increasing life expectancy and advances in cancer treatment will lead to more patients needing both radiation therapy (RT) and cardiac implantable electronic devices (CIEDs). CIEDs, including pacemakers and defibrillators, are essential for managing cardiac arrhythmias and heart failure. Telemetric monitoring of CIEDs checks battery status, lead function, settings, and diagnostic data, thereby identifying software deviations or damage. This study evaluates the German Society for Radiation Oncology (DEGRO)/German Society for Cardiology (DGK) guideline, assessing real-world complications and risk factors and analyzing pacemaker and implantable cardioverter-defibrillator (ICD) lead function for their predictive value concerning device malfunction. METHODS: A total of 54 patients with pacemakers or ICDs who underwent radiation therapy were identified. Demographics, treatment courses, and device information from physical and digital records were extracted. DEGRO/DGK risk groups and pacemaker dependency at the start of RT were assessed. Delineation of the devices and lead insertion sites was performed in the treatment planning system. Dosimetric information from the treatment plans was then correlated with reports of standardized device checks. RESULTS: Over 80% of patients were treated with dual-chamber pacemakers or cardiac resynchronization therapy (CRT), and 16.7% had ICDs. One third of patients were pacemaker dependent. 59.3% of patients were in the low-risk category, 29.3% in the medium-risk, and 11.1% in the high-risk category. Thoracic irradiation resulted in the highest median dose to devices. Lead parameter deviations exceeding thresholds were found in 14.8% for the stimulation threshold and 13.5% for sensing. Device malfunctions occurred in 3.7% of cases, both involving electrical resets and neutron-producing radiation (beam energy 10 megaelectron volt (MV) or higher). CONCLUSION: Collecting lead parameters in addition to secure malfunctions like electrical restarts and memory erasure revealed a significant proportion of treatment courses with temporary changes, though no correlation with individual treatment plans or adverse events was found. The focus on reducing neutron-producing radiation could be further supported. AU - Warmbrunn, J.* AU - Straube, C.* AU - Haase, H.U.* AU - Sinnecker, D.* AU - Laugwitz, K.L.* AU - Combs, S.E. AU - Schneider, S.* AU - Habermehl, D.* C1 - 72997 C2 - 56890 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 463-471 TI - Influence of radiotherapy on cardiac implantable devices and leads-a single-institution analysis and critical evaluation of current guidelines. JO - Strahlenther. Onkol. VL - 201 IS - 4 PB - Springer Heidelberg PY - 2025 SN - 0179-7158 ER - TY - JOUR AB - PURPOSE: The aim of this review was to evaluate the existing evidence for radiotherapy for brain metastases in breast cancer patients and provide recommendations for the use of radiotherapy for brain metastases and leptomeningeal carcinomatosis. MATERIALS AND METHODS: For the current review, a PubMed search was conducted including articles from 01/1985 to 05/2023. The search was performed using the following terms: (brain metastases OR leptomeningeal carcinomatosis) AND (breast cancer OR breast) AND (radiotherapy OR ablative radiotherapy OR radiosurgery OR stereotactic OR radiation). CONCLUSION AND RECOMMENDATIONS: Despite the fact that the biological subtype of breast cancer influences both the occurrence and relapse patterns of breast cancer brain metastases (BCBM), for most scenarios, no specific recommendations regarding radiotherapy can be made based on the existing evidence. For a limited number of BCBM (1-4), stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (SRT) is generally recommended irrespective of molecular subtype and concurrent/planned systemic therapy. In patients with 5-10 oligo-brain metastases, these techniques can also be conditionally recommended. For multiple, especially symptomatic BCBM, whole-brain radiotherapy (WBRT), if possible with hippocampal sparing, is recommended. In cases of multiple asymptomatic BCBM (≥ 5), if SRS/SRT is not feasible or in disseminated brain metastases (> 10), postponing WBRT with early reassessment and reevaluation of local treatment options (8-12 weeks) may be discussed if a HER2/Neu-targeting systemic therapy with significant response rates in the central nervous system (CNS) is being used. In symptomatic leptomeningeal carcinomatosis, local radiotherapy (WBRT or local spinal irradiation) should be performed in addition to systemic therapy. In patients with disseminated leptomeningeal carcinomatosis in good clinical condition and with only limited or stable extra-CNS disease, craniospinal irradiation (CSI) may be considered. Data regarding the toxicity of combining systemic therapies with cranial and spinal radiotherapy are sparse. Therefore, no clear recommendations can be given, and each case should be discussed individually in an interdisciplinary setting. AU - Borm, K.J.* AU - Behzadi, S.T.* AU - Hörner-Rieber, J.* AU - Krug, D.* AU - Baumann, R.* AU - Corradini, S.* AU - Duma, M.N.* AU - Dunst, J.* AU - Fastner, G.* AU - Feyer, P.* AU - Fietkau, R.* AU - Haase, W.* AU - Harms, W.* AU - Hehr, T.* AU - Matuschek, C.* AU - Piroth, M.D.* AU - Schmeel, L.C.* AU - Souchon, R.* AU - Strnad, V.* AU - Budach, W.* AU - Combs, S.E. C1 - 70243 C2 - 55460 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 259-275 TI - DEGRO guideline for personalized radiotherapy of brain metastases and leptomeningeal carcinomatosis in patients with breast cancer. JO - Strahlenther. Onkol. VL - 200 IS - 4 PB - Springer Heidelberg PY - 2024 SN - 0179-7158 ER - TY - JOUR AB - The rapid development of artificial intelligence (AI) has gained importance, with many tools already entering our daily lives. The medical field of radiation oncology is also subject to this development, with AI entering all steps of the patient journey. In this review article, we summarize contemporary AI techniques and explore the clinical applications of AI-based automated segmentation models in radiotherapy planning, focusing on delineation of organs at risk (OARs), the gross tumor volume (GTV), and the clinical target volume (CTV). Emphasizing the need for precise and individualized plans, we review various commercial and freeware segmentation tools and also state-of-the-art approaches. Through our own findings and based on the literature, we demonstrate improved efficiency and consistency as well as time savings in different clinical scenarios. Despite challenges in clinical implementation such as domain shifts, the potential benefits for personalized treatment planning are substantial. The integration of mathematical tumor growth models and AI-based tumor detection further enhances the possibilities for refining target volumes. As advancements continue, the prospect of one-stop-shop segmentation and radiotherapy planning represents an exciting frontier in radiotherapy, potentially enabling fast treatment with enhanced precision and individualization. AU - Erdur, A.C.* AU - Rusche, D.* AU - Scholz, D.* AU - Kiechle, J.* AU - Fischer, S.* AU - Llorián-Salvador, O.* AU - Buchner, J.A.* AU - Nguyen, M.Q.* AU - Etzel, L. AU - Weidner, J.* AU - Metz, M.C.* AU - Wiestler, B.* AU - Schnabel, J.A. AU - Rueckert, D.* AU - Combs, S.E. AU - Peeken, J.C. C1 - 71429 C2 - 56146 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany TI - Deep learning for autosegmentation for radiotherapy treatment planning: State-of-the-art and novel perspectives. JO - Strahlenther. Onkol. PB - Springer Heidelberg PY - 2024 SN - 0179-7158 ER - TY - JOUR AB - PURPOSE: This study compares the objective American Society of Anesthesiologists (ASA) and Adult Comorbidity Evaluation-27 (ACE-27) scores with the subjective Eastern Cooperative Oncology Group performance status (ECOG PS) for patient outcome prediction. METHODS: We retrospectively analyzed head and neck squamous cell carcinoma patients treated with adjuvant (chemo)radiotherapy at the LMU Munich from June 2008 to June 2015. The study focused on associations between patient outcomes; treatment failures; known risk factors (including human papillomavirus [HPV] status and tumor stage); and the comorbidity indices ECOG-PS, ASA score, and ACE-27. The Kaplan-Meier method and Cox proportional hazards model were used for survival analysis and identifying independent risk factors. RESULTS: A total of 302 patients were analyzed, 175 received concurrent chemotherapy. Median follow-up was 61.8 months, and median age at diagnosis was 61 years. The 3‑ and 5‑year overall survival (OS) and disease-free survival (DFS) rates were 70.5%/60.2% and 64.7%/57.6%, respectively. Both ACE-27 and ASA showed significant correlations with OS in univariate and multivariate analyses, while ECOG-PS was significant only in univariate analysis. ASA and ACE-27 scores were also significantly correlated with local and locoregional recurrence, but only HPV status and tumor stage were significant in multivariate models. CONCLUSION: ACE-27 and ASA score effectively categorize patients' risks in adjuvant radiotherapy for head and neck cancer, proving more predictive of overall survival than ECOG-PS. These results underscore the importance of objective comorbidity assessment and suggest further prospective studies. AU - Marschner, S. AU - Maihöfer, C. AU - Späth, R. AU - Haehl, E. AU - Reitz, D.* AU - Kienlechner, N. AU - Schüttrumpf, L. AU - Baumeister, P. AU - Pflugradt, U. AU - Hess J. AU - Zitzelsberger, H. AU - Unger, K. AU - Belka, C. AU - Walter, F. C1 - 71611 C2 - 56308 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany TI - Adjuvant (chemo)radiotherapy for patients with head and neck cancer: Can comorbidity risk scores predict outcome? JO - Strahlenther. Onkol. PB - Springer Heidelberg PY - 2024 SN - 0179-7158 ER - TY - JOUR AB - PURPOSE: To review existing scientific literature on mobile applications (apps) in the field of radiation oncology and to evaluate characteristics of commercially available apps across different platforms. METHODS: A systematic review of the literature for publications presenting apps in the field of radiation oncology was carried out using the PubMed database, Cochrane library, Google Scholar, and annual meetings of major radiation oncology societies. Additionally, the two major marketplaces for apps, App Store and Play Store, were searched for available radiation oncology apps for patients and health care professionals (HCP). RESULTS: A total of 38 original publications which met the inclusion criteria were identified. Within those publications, 32 apps were developed for patients and 6 for HCP. The vast majority of patient apps focused on documenting electronic patient-reported outcomes (ePROs). In the two major marketplaces, 26 apps were found, mainly supporting HCP with dose calculations. CONCLUSION: Apps used in (and for) scientific research in radiation oncology are rarely available for patients and HCP in common marketplaces. AU - Janssen, S.* AU - El Shafie, R.A.* AU - Ruder, A.M.* AU - Buergy, D.* AU - Scafa, D.* AU - Giordano, F.A.* AU - Nicolay, N.H.* AU - Vogel, M.M. AU - Combs, S.E. AU - Fahlbusch, F.B.* AU - Rades, D.* AU - Käsmann, L.* C1 - 67449 C2 - 54109 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 337-349 TI - Mobile applications in radiation oncology-current choices and future potentials. JO - Strahlenther. Onkol. VL - 199 IS - 4 PB - Springer Heidelberg PY - 2023 SN - 0179-7158 ER - TY - JOUR AB - PURPOSE: Spinal metastases (SM) are a common radiotherapy (RT) indication. There is limited level I data to drive decision making regarding dose regimen (DR) and target volume definition (TVD). We aim to depict the patterns of care for RT of SM among German Society for Radiation Oncology (DEGRO) members. METHODS: An online survey on conventional RT and Stereotactic Body Radiation Therapy (SBRT) for SM, distributed via e‑mail to all DEGRO members, was completed by 80 radiation oncologists between February 24 and April 29, 2022. Participation was voluntary and anonymous. RESULTS: A variety of DR was frequently used for conventional RT (primary: n = 15, adjuvant: n = 14). 30 Gy/10 fractions was reported most frequently. TVD in adjuvant RT was heterogenous, with a trend towards larger volumes. SBRT was offered in 65% (primary) and 21% (adjuvant) of participants' institutions. A variety of DR was reported (primary: n = 40, adjuvant: n = 27), most commonly 27 Gy/3 fractions and 30 Gy/5 fractions. 59% followed International Consensus Guidelines (ICG) for TVD. CONCLUSION: We provide a representative depiction of RT practice for SM among DEGRO members. DR and TVD are heterogeneous. SBRT is not comprehensively practiced, especially in the adjuvant setting. Further research is needed to provide a solid data basis for detailed recommendations. AU - Waltenberger, M.* AU - Vogel, M.M.E.* AU - Bernhardt, D.* AU - Münch, S.* AU - Dobiasch, S. AU - Redmond, K.J.* AU - Lo, S.S.* AU - Acker, G.* AU - Fehlings, M.G.* AU - Ringel, F.* AU - Vajkoczy, P.* AU - Meyer, B.* AU - Combs, S.E. C1 - 67851 C2 - 54329 SP - 159-174 TI - Radiotherapy concepts for spinal metastases-results from an online survey among radiation oncologists of the German Society for Radiation Oncology. JO - Strahlenther. Onkol. VL - 200 IS - 2 PY - 2023 SN - 0179-7158 ER - TY - JOUR AB - Purpose: Radiotherapy is a major pillar in the treatment of solid tumors including breast cancer. However, epidemiological studies have revealed an increase in cardiac diseases approximately a decade after exposure of the thorax to ionizing irradiation, which might be related to vascular inflammation. Therefore, chronic inflammatory effects were examined in primary heart and lung endothelial cells (ECs) of mice after local heart irradiation. Methods: Long-lasting effects on primary ECs of the heart and lung were studied 20–50 weeks after local irradiation of the heart of mice (8 and 16 Gy) in vivo by multiparameter flow cytometry using antibodies directed against cell surface markers related to proliferation, stemness, lipid metabolism, and inflammation, and compared to those induced by occlusion of the left anterior descending coronary artery. Results: In vivo irradiation of the complete heart caused long-lasting persistent upregulation of inflammatory (HCAM, ICAM‑1, VCAM-1), proliferation (CD105), and lipid (CD36) markers on primary heart ECs and an upregulation of ICAM‑1 and VCAM‑1 on primary ECs of the partially irradiated lung lobe. An artificially induced heart infarction induces similar effects with respect to inflammatory markers, albeit in a shorter time period. Conclusion: The long-lasting upregulation of prominent inflammatory markers on primary heart and lung ECs suggests that local heart irradiation induces chronic inflammation in the microvasculature of the heart and partially irradiated lung that leads to cardiac injury which might be related to altered lipid metabolism in the heart. AU - Wittmann, A.* AU - Bartels, A.* AU - Alkotub, Ab. AU - Bauer, L.* AU - Kafshgari, M.H.* AU - Multhoff, G.* C1 - 68331 C2 - 54751 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 1214-1224 TI - Chronic inflammatory effects of in vivo irradiation of the murine heart on endothelial cells mimic mechanisms involved in atherosclerosis. JO - Strahlenther. Onkol. VL - 199 IS - 12 PB - Springer Heidelberg PY - 2023 SN - 0179-7158 ER - TY - JOUR AB - PURPOSE: The Working Group for Neurooncology of the German Society for Radiation Oncology (DEGRO; AG NRO) in cooperation with members of the Neurooncological Working Group of the German Cancer Society (DKG-NOA) aimed to define a practical guideline for the diagnosis and treatment of radiation-induced necrosis (RN) of the central nervous system (CNS). METHODS: Panel members of the DEGRO working group invited experts, participated in a series of conferences, supplemented their clinical experience, performed a literature review, and formulated recommendations for medical treatment of RN, including bevacizumab, in clinical routine. CONCLUSION: Diagnosis and treatment of RN requires multidisciplinary structures of care and defined processes. Diagnosis has to be made on an interdisciplinary level with the joint knowledge of a neuroradiologist, radiation oncologist, neurosurgeon, neuropathologist, and neurooncologist. If the diagnosis of blood-brain barrier disruptions (BBD) or RN is likely, treatment should be initiated depending on the symptoms, location, and dynamic of the lesion. Multiple treatment options are available (such as observation, surgery, steroids, and bevacizumab) and the optimal approach should be discussed in an interdisciplinary setting. In this practice guideline, we offer detailed treatment strategies for various scenarios. AU - Bernhardt, D.* AU - Grosu, A.L.* AU - Rieken, S.* AU - Krieg, S.M.* AU - Wick, W.* AU - Wiestler, B.* AU - Schmidt-Graf, F.* AU - Sahm, F.* AU - Gempt, J.* AU - Meyer, B.* AU - Krause, B.J.* AU - Petersen, C.* AU - Fietkau, R.* AU - Thomas, M.A.* AU - Giordano, F.A.* AU - Wittig-Sauerwein, A.* AU - Tabatabai, G.* AU - Hau, P.* AU - Steinbach, J.* AU - Combs, S.E. C1 - 65959 C2 - 53004 SP - 971-980 TI - DEGRO practical guideline for central nervous system radiation necrosis part 2: Treatment. JO - Strahlenther. Onkol. VL - 198 IS - 11 PY - 2022 SN - 0179-7158 ER - TY - JOUR AB - PURPOSE: The Working Group for Neuro-Oncology of the German Society for Radiation Oncology in cooperation with members of the Neuro-Oncology Working Group of the German Cancer Society aimed to define a practical guideline for the diagnosis and treatment of radiation-induced necrosis (RN) of the central nervous system (CNS). METHODS: Panel members of the DEGRO working group invited experts, participated in a series of conferences, supplemented their clinical experience, performed a literature review, and formulated recommendations for medical treatment of RN including bevacizumab in clinical routine. CONCLUSION: Diagnosis and treatment of RN requires multidisciplinary structures of care and defined processes. Diagnosis has to be made on an interdisciplinary level with the joint knowledge of a neuroradiologist, radiation oncologist, neurosurgeon, neuropathologist, and neuro-oncologist. A multistep approach as an opportunity to review as many characteristics as possible to improve diagnostic confidence is recommended. Additional information about radiotherapy (RT) techniques is crucial for the diagnosis of RN. Misdiagnosis of untreated and progressive RN can lead to severe neurological deficits. In this practice guideline, we propose a detailed nomenclature of treatment-related changes and a multistep approach for their diagnosis. AU - Bernhardt, D.* AU - Grosu, A.* AU - Wiestler, B.* AU - Rieken, S.* AU - Wick, W.* AU - Gempt, J.* AU - Krieg, S.M.* AU - Schmidt-Graf, F.* AU - Sahm, F.* AU - Meyer, B.* AU - Krause, B.J.* AU - Petersen, C.* AU - Fietkau, R.* AU - Thomas, M.A.* AU - Giordano, F.A.* AU - Wittig-Sauerwein, A.* AU - Tabatabai, G.* AU - Hau, P.* AU - Steinbach, J.* AU - Combs, S.E. C1 - 65960 C2 - 53003 SP - 873-883 TI - DEGRO practical guideline for central nervous system radiation necrosis part 1: Classification and a multistep approach for diagnosis. JO - Strahlenther. Onkol. VL - 198 IS - 10 PY - 2022 SN - 0179-7158 ER - TY - JOUR AU - Kraus, K.M. AU - Combs, S.E. C1 - 63898 C2 - 51846 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 214-218 TI - Stereotaktisch ablative Strahlentherapie für operable nichtkleinzellige Bronchialkarzinome in Stadium I (überarbeitete STARS-Studie): Langzeitergebnisse einer einarmigen, prospektiven Studie mit Vergleich zur Operation. JO - Strahlenther. Onkol. VL - 198 IS - 2 PB - Springer Heidelberg PY - 2022 SN - 0179-7158 ER - TY - JOUR AB - Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has changed the lives of most humans worldwide. The aim of this study was to evaluate the impact of the SARS-CoV‑2 pandemic on health care professionals (HCPs) in radiation oncology facilities. Methods: We distributed an online survey to HCPs in radiation oncology (physicians, medical physics experts, radiology assistants/radiation therapists, nurses, and administrative personnel). The survey was completed by 334 participants between May 23 and June 9, 2020. Results: In 66.2% of the cases, HCPs reported a shortage of protective clothing. The protective measures were regarded as very reasonable by 47.4%, while 0.8% regarded them as not reasonable (rather reasonable: 44.0%; less reasonable 7.8%). 29.0% of the participants had children who needed care. The most frequently used care options were public emergency childcare (36.1%) and private childcare (e.g. relatives/friends). HCPs reported about additional work burden (fully agreed: 27.2%, rather agreed: 34.4%, less agreed: 28.2%, not agreed: 10.2%), and reduced work satisfaction (fully agreed: 11.7%, rather agreed: 29.6%, less agreed: 39.8%, not agreed: 18.9%). 12.9% and 29.0% of the participants were fully or rather mentally strained (less mentally strained: 44.0%, not mentally strained: 14.1%). Conclusion: We must learn from this pandemic how to prepare for further outbreaks and similar conditions. This includes the vast availability of protective clothing and efficient tracing of infection chains among the HCPs, but also secured childcare programs and experienced mental health support are crucial. Further, work satisfaction and appreciation by employers is essential. AU - Vogel, M.M. AU - Kessel, C.* AU - Eitz, K.A. AU - Combs, S.E. C1 - 64448 C2 - 52222 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 346-353 TI - Coronavirus disease 2019 and radiation oncology—survey on the impact of the severe acute respiratory syndrome coronavirus 2 pandemic on health care professionals in radiation oncology. JO - Strahlenther. Onkol. VL - 198 IS - 4 PB - Springer Heidelberg PY - 2022 SN - 0179-7158 ER - TY - JOUR AB - The new Medical Licensing Regulations 2025 (Ärztliche Approbationsordnung, ÄApprO) will soon be passed by the Federal Council (Bundesrat) and will be implemented step by step by the individual faculties in the coming months. The further development of medical studies essentially involves an orientation from fact-based to competence-based learning and focuses on practical, longitudinal and interdisciplinary training. Radiation oncology and radiation therapy are important components of therapeutic oncology and are of great importance for public health, both clinically and epidemiologically, and therefore should be given appropriate attention in medical education. This report is based on a recent survey on the current state of radiation therapy teaching at university hospitals in Germany as well as the contents of the National Competence Based Learning Objectives Catalogue for Medicine 2.0 (Nationaler Kompetenzbasierter Lernzielkatalog Medizin 2.0, NKLM) and the closely related Subject Catalogue (Gegenstandskatalog, GK) of the Institute for Medical and Pharmaceutical Examination Questions (Institut für Medizinische und Pharmazeutische Prüfungsfragen, IMPP). The current recommendations of the German Society for Radiation Oncology (Deutsche Gesellschaft für Radioonkologie, DEGRO) regarding topics, scope and rationale for the establishment of radiation oncology teaching at the respective faculties are also included. AU - Dapper, H.* AU - Belka, C.* AU - Bock, F.* AU - Budach, V.* AU - Budach, W.* AU - Christiansen, H.* AU - Debus, J.* AU - Distel, L.* AU - Dunst, J.* AU - Eckert, F.* AU - Eich, H.* AU - Eicheler, W.* AU - Engenhart-Cabillic, R.* AU - Fietkau, R.* AU - Fleischmann, D.F.* AU - Frerker, B.* AU - Giordano, F.A.* AU - Grosu, A.L.* AU - Herfarth, K.* AU - Hildebrandt, G.* AU - Kaul, D.* AU - Kölbl, O.* AU - Krug, D.* AU - Martin, D.* AU - Matuschek, C.* AU - Medenwald, D.* AU - Nicolay, N.H.* AU - Niewald, M.* AU - Oertel, M.* AU - Petersen, C.* AU - Pohl, F.* AU - Raabe, A.* AU - Rödel, C.* AU - Rübe, C.* AU - Schmalz, C.* AU - Schmeel, L.C.* AU - Steinmann, D.* AU - Stüben, G.* AU - Thamm, R.* AU - Vordermark, D.* AU - Vorwerk, H.* AU - Wiegel, T.* AU - Zips, D.* AU - Combs, S.E. C1 - 63570 C2 - 51593 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany TI - Integration of radiation oncology teaching in medical studies by German medical faculties due to the new licensing regulations: An overview and recommendations of the consortium academic radiation oncology of the German Society for Radiation Oncology (DEGRO). JO - Strahlenther. Onkol. PB - Springer Heidelberg PY - 2021 SN - 0179-7158 ER - TY - JOUR AB - Moderate hypofractionation is the standard of care for adjuvant whole-breast radiotherapy after breast-conserving surgery for breast cancer. Recently, 10-year results from the FAST and 5‑year results from the FAST-Forward trial evaluating adjuvant whole-breast radiotherapy in 5 fractions over 5 weeks or 1 week have been published. This article summarizes recent data for moderate hypofractionation and results from the FAST and FAST-Forward trial on ultra-hypofractionation. While the FAST trial was not powered for comparison of local recurrence rates, FAST-Forward demonstrated non-inferiority for two ultra-hypofractionated regimens in terms of local control. In both trials, the higher-dose experimental arms resulted in elevated rates of late toxicity. For the lower dose experimental arms of 28.5 Gy over 5 weeks and 26 Gy over 1 week, moderate or marked late effects were similar in the majority of documented items compared to the respective standard arms, but significantly worse in some subdomains. The difference between the standard arm and the 26 Gy of the FAST-Forward trial concerning moderate or marked late effects increased with longer follow-up in disadvantage of the experimental arm for most items. For now, moderate hypofractionation with 40–42.5 Gy over 15–16 fractions remains the standard of care for the majority of patients with breast cancer who undergo whole-breast radiotherapy without regional nodal irradiation after breast-conserving surgery. AU - Krug, D.* AU - Baumann, R.* AU - Combs, S.E. AU - Duma, M.N.* AU - Dunst, J.* AU - Feyer, P.* AU - Fietkau, R.* AU - Haase, W.* AU - Harms, W.* AU - Hehr, T.* AU - Piroth, M.D.* AU - Sedlmayer, F.* AU - Souchon, R.* AU - Strnad, V.* AU - Budach, W.* C1 - 61141 C2 - 50065 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 269-280 TI - Moderate hypofractionation remains the standard of care for whole-breast radiotherapy in breast cancer: Considerations regarding FAST and FAST-Forward. JO - Strahlenther. Onkol. VL - 197 IS - 4 PB - Springer Heidelberg PY - 2021 SN - 0179-7158 ER - TY - JOUR AB - Purpose: Scientific and clinical achievements in radiation, medical, and surgical oncology are changing the landscape of interdisciplinary oncology. The German Society for Radiation Oncology (DEGRO) working group of young clinicians and scientists (yDEGRO) and the DEGRO representation of associate and full professors (AKRO) are aware of the essential role of radiation oncology in multidisciplinary treatment approaches. Together, yDEGRO and AKRO endorsed developing a German radiotherapy & radiation oncology vision 2030 to address future challenges in patient care, research, and education. The vision 2030 aims to identify priorities and goals for the next decade in the field of radiation oncology. Methods: The vision development comprised three phases. During the first phase, areas of interest, objectives, and the process of vision development were defined jointly by the yDEGRO, AKRO, and the DEGRO board. In the second phase, a one-day strategy retreat was held to develop AKRO and yDEGRO representatives’ final vision from medicine, biology, and physics. The third phase was dedicated to vision interpretation and program development by yDEGRO representatives. Results: The strategy retreat’s development process resulted in conception of the final vision “Innovative radiation oncology Together – Precise, Personalized, Human.” The first term “Innovative radiation oncology” comprises the promotion of preclinical research and clinical trials and highlights the development of a national committee for strategic development in radiation oncology research. The term “together” underpins collaborations within radiation oncology departments as well as with other partners in the clinical and scientific setting. “Precise” mainly covers technological precision in radiotherapy as well as targeted oncologic therapeutics. “Personalized” emphasizes biology-directed individualization of radiation treatment. Finally, “Human” underlines the patient-centered approach and points towards the need for individual longer-term career curricula for clinicians and researchers in the field. Conclusion: The vision 2030 balances the ambition of physical, technological, and biological innovation as well as a comprehensive, patient-centered, and collaborative approach towards radiotherapy & radiation oncology in Germany. AU - Krug, D.* AU - Hecht, M.* AU - Ebert, N.* AU - Maurer, M.* AU - Fleischmann, D.F.* AU - Fokas, E.* AU - Straube, C.* AU - Nicolay, N.H.* AU - Hörner-Rieber, J.* AU - Schmitt, D.* AU - von Neubeck, C.* AU - Zamboglou, C.* AU - Sperk, E.* AU - Kaul, D.* AU - Hess J. AU - Corradini, S.* AU - Seidel, C.* AU - Gani, C.* AU - Baues, C.* AU - Frey, B.* AU - Blanck, O.* AU - Gauer, T.* AU - Niyazi, M.* C1 - 63011 C2 - 51212 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany TI - Innovative radiation oncology Together – Precise, Personalized, Human: Vision 2030 for radiotherapy & radiation oncology in Germany. JO - Strahlenther. Onkol. PB - Springer Heidelberg PY - 2021 SN - 0179-7158 ER - TY - JOUR AB - The original version of this article unfortunately contained mistakes. The name of the author Hess was corrected. Fig. 1 contained orthographic errors. Additionally, to ensure that the hyperlinks embedded in Fig. 1 can be accessed, Fig. 1 was added as Supplement 3. A reference to Supplement 3 has been added in the description of Fig. 1 in the article. The original article has been corrected. AU - Krug, D.* AU - Hecht, M.* AU - Ebert, N.* AU - Maurer, M.* AU - Fleischmann, D.F.* AU - Fokas, E.* AU - Straube, C.* AU - Nicolay, N.H.* AU - Hörner-Rieber, J.* AU - Schmitt, D.* AU - von Neubeck, C.* AU - Zamboglou, C.* AU - Sperk, E.* AU - Kaul, D.* AU - Hess J. AU - Corradini, S.* AU - Seidel, C.* AU - Gani, C.* AU - Baues, C.* AU - Frey, B.* AU - Blanck, O.* AU - Gauer, T.* AU - Niyazi, M.* C1 - 63417 C2 - 51356 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany TI - Correction to: Innovative radiation oncology Together-Precise, Personalized, Human. JO - Strahlenther. Onkol. PB - Springer Heidelberg PY - 2021 SN - 0179-7158 ER - TY - JOUR AB - This comprehensive review written by experts in their field gives an overview on the current status of incorporating positron emission tomography (PET) into radiation treatment planning. Moreover, it highlights ongoing studies for treatment individualisation and per-treatment tumour response monitoring for various primary tumours. Novel tracers and image analysis methods are discussed. The authors believe this contribution to be of crucial value for experts in the field as well as for policy makers deciding on the reimbursement of this powerful imaging modality. AU - Lapa, C.* AU - Nestle, U.* AU - Albert, N.L.* AU - Baues, C.* AU - Beer, A.* AU - Buck, A.* AU - Budach, V.* AU - Buetof, R.* AU - Combs, S.E. AU - Derlin, T.* AU - Eiber, M.* AU - Fendler, W.P.* AU - Furth, C.* AU - Gani, C.* AU - Gkika, E.* AU - Grosu, A.* AU - Henkenberens, C.* AU - Ilhan, H.* AU - Loeck, S.* AU - Marnitz-Schulze, S.* AU - Miederer, M.* AU - Mix, M.* AU - Nicolay, N.H.* AU - Niyazi, M.* AU - Poettgen, C.* AU - Rödel, C.M.* AU - Schatka, I.* AU - Schwarzenboeck, S.M.* AU - Todica, A.S.* AU - Weber, W.* AU - Wegen, S.* AU - Wiegel, T.* AU - Zamboglou, C.* AU - Zips, D.* AU - Zoephel, K.* AU - Zschaeck, S.* AU - Thorwarth, D.* AU - Troost, E.G.C.* C1 - 62724 C2 - 51026 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 1-23 TI - Value of PET imaging for radiation therapy. JO - Strahlenther. Onkol. VL - 197 IS - 9 PB - Springer Heidelberg PY - 2021 SN - 0179-7158 ER - TY - JOUR AU - Schiller, K.* AU - Combs, S.E. C1 - 62158 C2 - 50671 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 746-748 TI - Effektivität einer sequenziellen versus einer simultanen Radiochemotherapie oder alleinigen Radiotherapie bei der adjuvanten Behandlung des Zervixkarzinoms nach Hysterektomie. JO - Strahlenther. Onkol. VL - 197 IS - 8 PB - Springer Heidelberg PY - 2021 SN - 0179-7158 ER - TY - JOUR AB - Background: Emerging moderately hypofractionated and ultra-hypofractionated schemes for radiotherapy (RT) of prostate cancer (PC) have resulted in various treatment options. The aim of this survey was to evaluate recent patterns of care of German-speaking radiation oncologists for RT of PC. Methods: We developed an online survey which we distributed via e‑mail to all registered members of the German Society of Radiation Oncology (DEGRO). The survey was completed by 109 participants between March 3 and April 3, 2020. For evaluation of radiation dose, we used the equivalent dose at fractionation of 2 Gy with α/β = 1.5 Gy, equivalent dose (EQD2 [1.5 Gy]). Results: Median EQD2(1.5 Gy) for definitive RT of the prostate is 77.60 Gy (range: 64.49–84.00) with median single doses (SD) of 2.00 Gy (range: 1.80–3.00), while for postoperative RT of the prostate bed, median EQD2(1.5 Gy) is 66.00 Gy (range: 60.00–74.00) with median SD of 2.00 Gy (range: 1.80–2.00). For definitive RT, the pelvic lymph nodes (LNs) are treated in case of suspect findings in imaging (82.6%) and/or according to risk formulas/tables (78.0%). In the postoperative setting, 78.9% use imaging and 78.0% use the postoperative tumor stage for LN irradiation. In the definitive and postoperative situation, LNs are irradiated with a median EQD2(1.5 Gy) of 47.52 Gy with a range of 42.43–66.00 and 41.76–62.79, respectively. Conclusion: German-speaking radiation oncologists’ patterns of care for patients with PC are mainly in line with the published data and treatment recommendation guidelines. However, dose prescription is highly heterogenous for RT of the prostate/prostate bed, while the dose to the pelvic LNs is mainly consistent. AU - Vogel, M.M. AU - Dewes, S.* AU - Sage, E.K.* AU - Devecka, M.* AU - Gschwend, J.E.* AU - Schiller, K.* AU - Combs, S.E. C1 - 61147 C2 - 50064 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 962-970 TI - Patterns of care for prostate cancer radiotherapy—results from a survey among German-speaking radiation oncologists. JO - Strahlenther. Onkol. VL - 197 IS - 11 PB - Springer Heidelberg PY - 2021 SN - 0179-7158 ER - TY - JOUR AU - Bartzsch, S. AU - Winter, J. AU - Matejcek, C.* AU - Wilkens, J.J.* AU - Aulenbacher, K.* AU - Combs, S.E. C1 - 60212 C2 - 51875 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S207-S207 TI - Micro-radiation Therapy on a compact Radiation Source. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Bernhardt, D.* AU - Combs, S.E. C1 - 59487 C2 - 48842 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 743-746 TI - Zielvolumenreduktion durch 18F-FDG-PET/CT-basierte „involved field“ Bestrahlung beim fortgeschrittenen NSCLC möglicherweise neuer Standard: Ergebnisse der PET-Plan-Studie. JO - Strahlenther. Onkol. VL - 196 IS - 8 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Bicher, S. AU - Schroepfer, L.* AU - Azimzadeh, O. AU - Tapio, S. AU - Combs, S.E. AU - Schmid, T.E. AU - Bartzsch, S. C1 - 60200 C2 - 50265 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S189-S189 TI - The protection of healthy tissues in radiation therapy by spatial fractionation. JO - Strahlenther. Onkol. VL - 196 IS - SUPPL 1 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AB - Purpose Lymph node irradiation in breast cancer has gained complexity due to recently published studies and technical innovations which then led to changes in international guidelines. We sought to determine real-time variability in lymph node irradiation in clinical practice in German-speaking countries. Methods The Department of Radiation Oncology, Technical University of Munich (TUM), developed an online-based questionnaire focusing on the indication, target definition, and treatment technique of lymph node irradiation in patients with breast cancer. The invitation to participate in the survey was sent to members of the German Society of Radiation Oncology (DEGRO) by e-mail. The results of the survey were exported from the online platform into SPSS for a detailed analysis. Results In total, 100 physicians completed the questionnaire between 05/2019 and 06/2019. Despite the existence of several treatment and contouring guidelines, we observed large variability of lymph node irradiation: The guideline recommendation for internal mammary irradiation is not consistently implemented in clinical practice and irradiation of the axilla after positive SLNB (sentinel lymph node biopsy) or ALND (axillary lymph node dissection) is handled very differently. Furthermore, in most clinics, the ESTRO (European Society for Therapeutic Radiology and Oncology) contouring consensus is not used, and PTV (planning target volume) definitions and margins vary considerably. Conclusion Further clinical studies should be performed with a particular focus on radiotherapy for lymphatic drainage to support and amend the existing guidelines. These studies should establish a more standardized treatment of the lymph node regions in clinical practice. Quality assurance should enforce broad implementation of consensus recommendations. AU - Borm, K.J.* AU - Kessel, K.* AU - Devecka, M.* AU - Muench, S.* AU - Straube, C.* AU - Schiller, K.* AU - Schüttrumpf, L.* AU - Dapper, H.* AU - Wöller, B.* AU - Pigorsch, S.* AU - Combs, S.E. C1 - 57327 C2 - 47726 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 15–22 TI - Variability in lymph node irradiation in patients with breast cancer-results from a multi-center survey in German-speaking countries. JO - Strahlenther. Onkol. VL - 196 IS - 1 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AB - Objective Tangential field irradiation in breast cancer potentially treats residual tumor cells in the axilla after sentinel lymph node biopsy (SLNB). In recent years, hypofractionated radiotherapy has gained importance and currently represents the recommended standard in adjuvant breast cancer treatment for many patients. So far, the impact of hypofractionation on the effect of incidental lymph node irradiation has not be addressed. Materials and methods Biological effective dose (BED) and tumor control probability (TCP) were estimated for four different hypofractionated radiation schemes (42.50 & x202f;Gy in 16 fractions [Fx]; 40.05 & x202f;Gy in 15 Fx; 27 & x202f;Gy in 5 Fx; and 26 in 5 Fx) and compared to conventional fractionation (50 & x202f;Gy in 25 Fx). For calculation of BED and TCP, a previously published radiobiological model with an alpha/beta ratio of 4 & x202f;Gy was used. The theoretical BED and TCP for incidental irradiation between 0 and 100% of the prescribed dose were evaluated. Subsequently, we assessed BED and TCP in 431 axillary lymph node metastases. Results The extent of incidental lymph node irradiation and the fractionation scheme have a direct impact on BED and TCP. The estimated mean TCP in the axillary nodes ranged from 1.5 & x202f;+/- 6.4% to 57.5 & x202f;+/- 22.9%, depending on the patient's anatomy and the fractionation scheme. Hypofractionation led to a significant reduction of mean TCP of lymph node metastases for all schedules. Conclusion Our data indicate that hypofractionation might affect the effectiveness of incidental radiotherapy in the axilla. This is particularly relevant for patients with positive sentinel lymph nodes who receive SLNB only. AU - Borm, K.J.* AU - Oechsner, M.* AU - Düsberg, M.* AU - Buschner, G.* AU - Wolfgang, W.* AU - Combs, S.E. AU - Duma, M.N.* C1 - 59273 C2 - 48708 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 771–778 TI - Effect of hypofractionation on the incidental axilla dose during tangential field radiotherapy in breast cancer. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Borm, K.J. AU - Simonetto, C. AU - Kundrát, P. AU - Eidemüller, M. AU - Oechsner, M. AU - Duesberg, M. AU - Combs, S.E. C1 - 60198 C2 - 49874 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S139-S139 TI - Adjuvant Irradiation of the internal Mammary Lymph Nodes of Patients with Breast Cancer. How high is the additional Toxicity when Using modern Radiation Techniques? JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Combs, S.E. AU - Atkinson, M.J. C1 - 59686 C2 - 48909 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 747–748 TI - Happy birthday, Klaus-Rudiger! Heartfelt appreciation on the occasion of the 80th birthday of Professor Klaus-Rudiger Trott. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AB - Background There are different contouring guidelines for definition of the clinical target volume (CTV) for intensity-modulated radiation therapy (IMRT) of anal cancer (AC). We conducted a planning comparison study to evaluate and compare the dose to relevant organs at risk (OARs) while using different CTV definitions. Methods Twelve patients with a primary diagnosis of anal cancer, who were treated with primary chemoradiation (CRT), were selected. We generated four guideline-specific CTVs and subsequently planned target volumes (PTVs) on the planning CT scan of each patient. An IMRT plan for volumetric arc therapy (VMAT) was set up for each PTV. Dose parameters of the planned target volume (PTV) and OARs were evaluated and compared, too. Results The mean volume of the four PTVs ranged from 2138 cc to 2433 cc. The target volumes contoured by the authors based on the recommendations of each group were similar in the pelvis, while they differed significantly in the inguinal region. There were no significant differences between the four target volumes with regard to the dose parameters of the cranially located OARs. Conversely, some dose parameters concerning the genitals and the skin varied significantly among the different guidelines. Conclusion The four contouring guidelines differ significantly concerning the inguinal region. In order to avoid inguinal recurrence and to protect relevant OARs, further investigations are needed to generate uniform standards for definition of the elective clinical target volume in the inguinal region. AU - Dapper, H.* AU - Oechsner, M.* AU - Münch, S.* AU - Diehl, C.* AU - Peeken, J.C. AU - Borm, K.* AU - Combs, S.E. C1 - 58027 C2 - 48208 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 368–375 TI - Dosimetric comparison of organs at risk using different contouring guidelines for definition of the clinical target volume in anal cancer. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AB - Purpose: Education as part of medical education is currently changing rapidly. Not least because of the corona crisis, more and more digital teaching formats and innovative teaching concepts such as the flipped classroom model are finding their way into teaching. We analyzed the acceptance and effectiveness of traditional teaching methods as well as the interest in innovative e‑learning methods among medical students in the field of radiation oncology at the medical school of the Technical University of Munich. Methods: We carried out an online-based survey as well as a knowledge test on all students from two terms who had completed the seminar series of radiation oncology. The survey comprised seven questions on the frequency of participation, acceptance, and judgment of the effectiveness in terms of learning and on a potential use of e‑learning methods using a six-point Likert scale. The test consisted of 10 multiple-choice questions. Results: Traditional teaching methods are largely accepted by students and most students consider the current learning format to be effective in terms of the teaching effect in the field of radiation oncology. However, only about 50% of all knowledge questions were answered correctly. The possible use of e‑learning methods was judged critically or desired in roughly equal parts among the students. Conclusion: Traditional seminars enjoy a high level of acceptance among students. Effectiveness with regard to the internalization of content taught, however, should be increased. After all, the future seems to lie in the integration of e‑learning in the form of educational videos and practical seminars. AU - Dapper, H.* AU - Wijnen-Meijer, M.* AU - Rathfelder, S.* AU - Mosene, K.* AU - von Kirchbauer, I.* AU - Bernhardt, D.* AU - Berberat, P.O.* AU - Combs, S.E. C1 - 60593 C2 - 49404 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany TI - Radiation oncology as part of medical education—current status and possible digital future prospects. JO - Strahlenther. Onkol. PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Devecka, M.* AU - Dewes, S.* AU - Duesberg, M.* AU - Muench, S.* AU - Schiller, K. AU - Eiber, M.* AU - Gschwend, J.E.* AU - Combs, S.E. C1 - 60216 C2 - 49830 SP - S92-S92 TI - Analysis of the local recurrence pattern after radical prostatectomy in PSMA-PET-based radiotherapy planning. JO - Strahlenther. Onkol. VL - 196 IS - SUPPL 1 PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Dobiasch, S. AU - Kampfer, S.* AU - Schilling, D. AU - Kessler, C.* AU - Reichert, M.* AU - Wilkens, J.J.* AU - Combs, S.E. C1 - 60214 C2 - 51873 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S7-S7 TI - High-Precision Radiotherapy in clinically relevant Tumor Mouse Models to implement personalized clinical Trials in Radiooncology. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Drexler, G.A. AU - Klymenko, O. AU - Baumeister, P. AU - Weber, P. AU - Heider, T. AU - Selmansberger, M. AU - Zitzelsberger, H. AU - Unger, K. AU - Hess J. AU - Schoetz, U.* AU - Belka, C. AU - Lauber, K. C1 - 60199 C2 - 49875 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S49-S50 TI - Patient-derived HNSCC cell lines and subclones reflect inter- and intra-tumoral heterogeneity regarding various molecular and phenotypic aspects. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Eckert, D.* AU - Subedi, P. AU - Hehlgans, S.* AU - Martin, D.* AU - Roedel, C.* AU - Lumniczky, K.* AU - Tapio, S. AU - Roedel, F.* C1 - 60201 C2 - 50266 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S186-S187 TI - Characterization of serum-derived extracellular vesicles from leukaemic patients to identify leukaemic and radiation biomarkers. JO - Strahlenther. Onkol. VL - 196 IS - SUPPL 1 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Fleischmann, D.F.* AU - Unger, K. AU - Ruf, V.* AU - Heider, T. AU - Hess J. AU - Drexler, G.* AU - Herms, J.* AU - Thon, N.* AU - Kreth, F.-.* AU - Tonn, J.-.* AU - Zitzelsberger, H. AU - Lauber, K. AU - Belka, C. AU - Niyazi, M. C1 - 60202 C2 - 51848 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S119-S120 TI - Risk Stratification of Glioblastoma Patients using Blood Plasma Samples. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Hansel, C.* AU - Wiesemann, A.* AU - Lauber, K.* AU - Hess J. AU - Unger, K. AU - Zitzelsberger, H. AU - Jendrossek, V.* AU - Klein, D.* C1 - 60204 C2 - 51850 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S184-S184 TI - Radiation-induced senescence as potential target for normal tissue protection. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Hofmann, C.* AU - Borm, K.J.* AU - Oechsner, M.* AU - Duesberg, M.* AU - Combs, S.E. C1 - 60210 C2 - 51877 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S140-S141 TI - Internal Mammary Irradiation Technique in Patients with Breast Cancer. What is the Influence of CTV-PTV Safety Margins? JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Huber, K.* AU - Gomolka, M.* AU - Thomsen, A.R.* AU - Hauck, S.M. AU - Duchrow, L.* AU - Ordonez, M.E.B.* AU - Henke, M.* AU - Moertl, S.* AU - Hornhardt, S.* C1 - 60209 C2 - 51878 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S191-S191 TI - Characterization of radiation-induced Normal Tissue Reactions in a Head and Neck Tumor Patient Collective. JO - Strahlenther. Onkol. VL - 196 IS - SUPPL 1 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Kern, J. AU - Dobiasch, S. AU - Schilling, D. AU - Schneider, C.* AU - Schneider, G.* AU - Schmid, R.M.* AU - Combs, S.E. C1 - 60211 C2 - 51876 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S193-S193 TI - Identification of Biomarkers for the Prediction of Radiation Sensitivity in ductal Adenocarcinoma of the Pancreas by means of Gene Set Enrichment Analysis. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Kirstein, A. AU - Schilling, D. AU - Combs, S.E. AU - Schmid, T.E. C1 - 60205 C2 - 51851 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S185-S185 TI - Influence of MGMT expression on the radiation sensitivity of human glioblastoma cell lines. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Kraus, K.M.* AU - Oechsner, M.* AU - Wilkens, J.J. AU - Combs, S.E. C1 - 60197 C2 - 49873 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S13-S13 TI - Stereotactic Irradiation of peripheral Lung Tumors using Respiratory Gating: Correlation between PTV Reduction, Tumor Movement and Volume Dose. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AB - Purpose The aim of this study was to investigate whether bone mineral density (BMD) as measured in planning computed tomographies (CTs) by a new method is a risk factor for pelvic insufficiency fractures (PIF) after radio(chemo)therapy (R(C)T) for cervical cancer. Methods 62 patients with cervical cancer who received definitive or adjuvant radio(chemo)therapy between 2013 and 2017 were reviewed. The PIF were detected on follow-up magntic resonance imaging (MRI). The MRI of the PIF patients was registered to the planning CT and the PIF contoured. On the contralateral side of the fracture, a mirrored structure of the fracture was generated (mPIF). For the whole sacral bone, three lumbar vertebrae, the first and second sacral vertebrae, and the PIF, we analyzed the BMD (mg/cm(3)), V50Gy, Dmean, and Dmax. Results Out of 62 patients, 6 (9.7%) had a fracture. Two out of the 6 patients had a bilateral fracture with only one of them being symptomatic. PIF patients showed a significantly lower BMD in the sacral and the lumbar vertebrae (p< 0.05). The BMD of the contoured PIF, however, when comparing to the mPIF, did not reach significance (p< 0.49). The difference of the V50Gy of the sacrum in the PIF group compared to the other (OTH) patients, i.e. those without PIF, did not reach significance. Conclusion The dose does not seem to have a relevant impact on the incidence of PIF in our patients. One of the predisposing factors for developing PIF after radiotherapy seems to be the low BMD. We presented an easy method to assess the BMD in planning CTs. AU - Kurrumeli, D.* AU - Oechsner, M.* AU - Weidenbächer, B.* AU - Brambs, C.* AU - Löffler, M.* AU - Combs, S.E. AU - Borm, K.* AU - Duma, M.N.* C1 - 60278 C2 - 49326 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 487-493 TI - An easy way to determine bone mineral density and predict pelvic insufficiency fractures in patients treated with radiotherapy for cervical cancer. JO - Strahlenther. Onkol. VL - 197 IS - 6 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Lang, D.M. AU - Peeken, J.C. AU - Asadpour, R.* AU - Spraker, M.B.* AU - Nyflot, M.J.* AU - Combs, S.E. AU - Wilkens, J.J.* AU - Bartzsch, S. C1 - 60218 C2 - 51871 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S33-S33 TI - Soft tissue sarcoma contouring based on planning CTs using deep learning. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Maier, S.H.* AU - Hennel, R.* AU - Mutlu, S.* AU - Osterode, E.* AU - Mahajan, U.M.* AU - Mayerle, J.* AU - Belka, C. AU - Lauber, K. C1 - 60213 C2 - 51874 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S188-S188 TI - Combination of EGFR-specific, 5-FU-bearing Aptamers with Radiation: Characterization in in vitro Models of Squamous Cell Carcinoma of the Head and Neck Region (HNSCC). JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AB - Purpose COVID-19 infection has manifested as a major threat to both patients and healthcare providers around the world. Radiation oncology institutions (ROI) deliver a major component of cancer treatment, with protocols that might span over several weeks, with the result of increasing susceptibility to COVID-19 infection and presenting with a more severe clinical course when compared with the general population. The aim of this manuscript is to investigate the impact of ROI protocols and performance on daily practice in the high-risk cancer patients during this pandemic. Methods We addressed the incidence of positive COVID-19 cases in both patients and health care workers (HCW), in addition to the protective measures adopted in ROIs in Germany, Austria and Switzerland using a specific questionnaire. Results The results of the questionnaire showed that a noteworthy number of ROIs were able to complete treatment in SARS-CoV-2 positive cancer patients, with only a short interruption. The ROIs reported a significant decrease in patient volume that was not impacted by the circumambient disease incidence, the type of ROI or the occurrence of positive cases. Of the ROIs 16.5% also reported infected HCWs. About half of the ROIs (50.5%) adopted a screening program for patients whereas only 23.3% also screened their HCWs. The range of protective measures included the creation of working groups, instituting home office work and protection with face masks. Regarding the therapeutic options offered, curative procedures were performed with either unchanged or moderately decreased schedules, whereas palliative or benign radiotherapy procedures were more often shortened. Most ROIs postponed or cancelled radiation treatment for benign indications (88.1%). The occurrence of SARS-CoV-2 infections did not affect the treatment options for curative procedures. Non-university-based ROIs seemed to be more willing to change their treatment options for curative and palliative cases than university-based ROIs. Conclusion Most ROIs reported a deep impact of SARS-CoV-2 infections on their work routine. Modification and prioritization of treatment regimens and the application of protective measures preserved a well-functioning radiation oncology service and patient care. AU - Matuschek, C.* AU - Fischer, J.C.* AU - Combs, S.E. AU - Fietkau, R.* AU - Corradini, S.* AU - Zänker, K.* AU - Bölke, E.* AU - Djiepmo-Njanang, F.J.* AU - Tamaskovics, B.* AU - Fischer, J.E.* AU - Stuschke, M.* AU - Pöttgen, C.* AU - Förster, R.* AU - Zwahlen, D.R.* AU - Papachristofilou, A.* AU - Ganswindt, U.* AU - Pelka, R.* AU - Schneider, E.M.* AU - Feldt, T.* AU - Jensen, B.E.O.* AU - Häussinger, D.* AU - Knoefel, W.T.* AU - Kindgen-Milles, D.* AU - Pedoto, A.* AU - Grebe, O.* AU - van Griensven, M.* AU - Budach, W.* AU - Haussmann, J.* C1 - 60068 C2 - 49219 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 1068-1079 TI - Measures of infection prevention and incidence of SARS-CoV-2 infections in cancer patients undergoing radiotherapy in Germany, Austria and Switzerland. JO - Strahlenther. Onkol. VL - 196 IS - 12 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Muench, S.* AU - Devecka, M.* AU - Oechsner, M.* AU - Friess, H.* AU - Combs, S.E. C1 - 60208 C2 - 51879 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S152-S152 TI - Combined neoadjuvant/definitive Chemoradiotherapy in Patients with Oesophageal carcinoma and irresectable Lymph Node Metastases. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AB - Purpose In patients undergoing chemoradiation for esophageal squamous cell carcinoma (ESCC), the extent of elective nodal irradiation (ENI) is still discussed controversially. This study aimed to analyze patterns of lymph node metastases and their correlation with the primary tumor using F-18-fludeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans. Methods 102 ESCC patients with pre-treatment FDG-PET/CT scans were evaluated retrospectively. After exclusion of patients with low FDG uptake and patients without FDG-PET-positive lymph node metastases (LNM), 76 patients were included in the final analysis. All LNM were assigned to 16 pre-defined anatomical regions and classified according to their position relative to the primary tumor (above, at the same height, or below the primary tumor). In addition, the longitudinal distance to the primary tumor was measured for all LNM above or below the primary tumor. The craniocaudal extent (i.e., length) of the primary tumor was measured using FDG-PET imaging (L-PET) and also based on all other available clinical and imaging data (endoscopy, computed tomography, biopsy results) except FDG-PET (L-CT/EUS). Results Significantly more LNM were identified with F-18-FDG-PET/CT (177 LNM) compared to CT alone (131 LNM, p & x202f;< 0.001). The most common sites of LNM were paraesophageal (63% of patients, 37% of LNM) and paratracheal (33% of patients, 20% of LNM), while less than 5% of patients had supraclavicular, subaortic, diaphragmatic, or hilar LNM. With regard to the primary tumor, 51% of LNM were at the same height, while 25% and 24% of lymph node metastases were above and below the primary tumor, respectively. For thirty-three LNM (19%), the distance to the primary tumor was larger than 4 & x202f;cm. No significant difference was seen between L-CT/EUS (median 6 & x202f;cm) and L-PET (median 6 & x202f;cm, p & x202f;= 0.846) Conclusion F-18-FDG-PET can help to identify subclinical lymph node metastases which are located outside of recommended radiation fields. PET-based involved-field irradiation might be the ideal compromise between small treatment volumes and decreasing the risk of undertreatment of subclinical metastatic lymph nodes and should be further evaluated. AU - Münch, S.* AU - Marr, L.* AU - Feuerecker, B.* AU - Dapper, H.* AU - Braren, R.* AU - Combs, S.E. AU - Duma, M.N.* C1 - 59171 C2 - 48652 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 787-794 TI - Impact of F-18-FDG-PET/CT on the identification of regional lymph node metastases and delineation of the primary tumor in esophageal squamous cell carcinoma patients. JO - Strahlenther. Onkol. VL - 196 IS - 9 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Mutlu, S.* AU - Unger, K. AU - Brix, N.* AU - Heider, T. AU - Maier, S.* AU - Branz, P.* AU - Hess J. AU - Belka, C. AU - Zitzelsberger, H. AU - Lauber, K. C1 - 60206 C2 - 51852 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S189-S190 TI - Intrinsic radioresistance and intra-tumoral heterogeneity in HNSCC. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Peeken, J.C. AU - Shouman, M.A.* AU - Kroenke, M.* AU - Rauscher, I.* AU - Maurer, T.* AU - Gschwend, J.E.* AU - Eiber, M.* AU - Combs, S.E. C1 - 60217 C2 - 51872 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S28-S29 TI - Development and Validation of a CT-based Radiomic Model for the Detection of Lymph Node Metastases in Patients with recurrent Prostate Cancer. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Peeken, J.C. AU - Navarro, F.* AU - Spraker, M.B.* AU - Lang, D.* AU - Bartzsch, S. AU - Nyflot, M.J.* AU - Menze, B.H.* AU - Combs, S.E. C1 - 60219 C2 - 51870 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S33-S34 TI - Improved survival prediction in patients with soft tissue sarcoma through the application of deep learning. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AB - In the current dismal situation of the COVID-19 pandemic, effective management of patients with pneumonia and acute respiratory distress syndrome is of vital importance. Due to the current lack of effective pharmacological concepts, this situation has caused interest in (re)considering historical reports on the treatment of patients with low-dose radiation therapy for pneumonia. Although these historical reports are of low-level evidence per se, hampering recommendations for decision-making in the clinical setting, they indicate effectiveness in the dose range between 0.3 and 1 & x202f;Gy, similar to more recent dose concepts in the treatment of acute and chronic inflammatory/degenerative benign diseases with, e.g., a single dose per fraction of 0.5 & x202f;Gy. This concise review aims to critically review the evidence for low-dose radiation treatment of COVID-19 pneumopathy and discuss whether it is worth investigating in the present clinical situation. AU - Rödel, F.* AU - Arenas, M.* AU - Ott, O.J.* AU - Fournier, C.* AU - Georgakilas, A.G.* AU - Tapio, S. AU - Trott, K.R.* AU - Gaipl, U.S.* C1 - 59139 C2 - 48594 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 679-682 TI - Low-dose radiation therapy for COVID-19 pneumopathy: What is the evidence? JO - Strahlenther. Onkol. VL - 196 IS - 8 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Sage, E.K.* AU - Vogel, M.M.E.* AU - Dewes, S.* AU - Devecka, M.* AU - Eiber, M.* AU - Gschwend, J.E.* AU - Combs, S.E. AU - Schiller, K.* C1 - 60220 C2 - 51880 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S160-S161 TI - Stereotactic Body Radiotherapy (SBRT) for the Treatment of oligometastatic Prostate Carcinoma. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AB - Background and purpose Radiotherapy (RT) is persistently gaining significance in the treatment of pediatric tumors. However, individual features of a growing body and multifocal stages complicate this approach. Tomotherapy offers advantages in the treatment of anatomically complex tumors with low risks of side effects. Here we report on toxicity incidence and outcome of tomotherapy with a focus on multitarget RT (mtRT). Materials and methods From 2008 to 2017, 38 children diagnosed with sarcoma were treated with tomotherapy. The median age was 15 years (6-19 years). Toxicity was graded according to the Common Terminology Criteria for Adverse Events v.4.03 and classified into symptoms during RT, acutely (0-6 months) and late (>6 months) after RT, and long-term sideeffects (>24 months). Results The main histologies were Ewing sarcoma (n & x202f;= 23 [61%]) and alveolar rhabdomyosarcoma (n & x202f;= 5 [13%]). RT was performed with a median total dose of 54 & x202f;Gy (40.5-66.0 & x202f;Gy) and a single dose of 2 & x202f;Gy (1.80-2.27 & x202f;Gy). Twenty patients (53%) received mtRT. Median follow-up was 29.7 months (95% confidence interval 15.3-48.2 months) with a 5-year survival of 55.2% (+/- 9.5%). The 5-year survival rate of patients with mtRT (n & x202f;= 20) was 37.1 & x202f;+/- 13.2%, while patients who received single-target RT (n & x202f;= 18) had a 5-year survival rate of 75 & x202f;+/- 10.8%. Severe toxicities (grade 3 and 4) emerged in 14 patients (70%) with mtRT and 7 patients (39%) with single-target RT. Two non-hematological grade 4 toxicities occurred during RT: one mucositis and one radiodermatitis. After mtRT 5 patients had grade 3 toxicities acute and after single-target RT 4 patients. One patient had acute non-hematological grade 4 toxicities (gastritis, pericarditis, and pericardial effusion) after mtRT. Severe late effects of RT occurred in 2 patients after mtRT and in none of the single-target RT patients. No severe long-term side effects appeared. Conclusion Our results showed acceptable levels of acute and late toxicities, considering the highly advanced diseases and multimodal treatment. Hence, tomotherapy is a feasible treatment method for young patients with anatomically complex tumors or multiple targets. Especially mtRT is a promising and innovative treatment approach for pediatric sarcomas, delivering unexpectedly high survival rates for patients with multifocal Ewing sarcomas in this study, whereby the limited number of patients should invariably be considered in the interpretation. AU - Salfelder, M.A.* AU - Kessel, K.A. AU - Thiel, U.* AU - Burdach, S.* AU - Kampfer, S.* AU - Combs, S.E. C1 - 59841 C2 - 49067 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 1103–1115 TI - Prospective evaluation of multitarget treatment of pediatric patients with helical intensity-modulated radiotherapy. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Schmid, T.E. AU - Hunger, A. AU - Sammer, M.* AU - Bicher, S. AU - Schauer, J.* AU - Schwarz, B.* AU - Rudigkeit, S.* AU - Matejka, N.* AU - Bartzsch, S. AU - Dollinger, G.* AU - Ilicic, K. AU - Reindl, J.* AU - Combs, S.E. C1 - 60098 C2 - 49847 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S109-S109 TI - Proton minibeam radiation therapy-an innovative strategy in cancer treatment. JO - Strahlenther. Onkol. VL - 196 IS - SUPPL 1 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Schmidt-Hegemann, N.-S.* AU - Hess J. AU - Unger, K. AU - Link, V.* AU - Buchner, A.* AU - Eze, C.* AU - Li, M.* AU - Stief, C.* AU - Kirchner, T.* AU - Ganswindt, U.* AU - Zitzelsberger, H. AU - Belka, C.* C1 - 60203 C2 - 51849 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S158-S159 TI - DNA copy number and DNA methylome analysis of primary prostate cancer and pathologic lymph node metastases in patients with low and high Gleason score. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Schrickel, F. AU - Wank, M. AU - Meyer, B.* AU - Gempt, J.* AU - Barz, M.* AU - Thomsen, A.R.* AU - Schmid, T.E. AU - Combs, S.E. AU - Schilling, D. C1 - 60221 C2 - 50541 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S109-S110 TI - Heterogeneous invasion capacity of patient-derived primary glioblastoma multiforme cells. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Vogel, M.M. AU - Kessel, K.A. AU - Eiber, M.* AU - Gschwend, J.E.* AU - Combs, S.E. AU - Schiller, K.* C1 - 60222 C2 - 50309 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S160-S160 TI - Toxicity of PSMA-PET-based Salvage Radiotherapy with a simultaneous integrated Boost for Patients with Recurrence of Prostate Cancer after radical Prostatectomy. JO - Strahlenther. Onkol. VL - 196 IS - SUPPL 1 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Waltenberger, M.* AU - Kessel, K.A. AU - Devecka, M.* AU - Peeken, J.C. AU - Combs, S.E. C1 - 60207 C2 - 51853 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S16-S16 TI - Stereotactic body radiation therapy of spine metastases using a simultaneous integrated boost concept-evaluation of effectiveness and toxicity. JO - Strahlenther. Onkol. VL - 196 PB - Springer Heidelberg PY - 2020 SN - 0179-7158 ER - TY - JOUR AU - Al Bazaz, M.* AU - Selmansberger, M. AU - Engenhart-Cabillic, R.* AU - Lauber, K.* AU - Schoetz, U.* C1 - 56257 C2 - 46934 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S127-S127 TI - Tumor stem cell factor CD44v6 influences G2 arrest and radiation sensitivity in S phase after irradiation. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Asadpour, R.* AU - Pigorsch, S.U.* AU - Combs, S.E. C1 - 56236 C2 - 46926 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S134-S134 TI - Unexpected discontinuations in patients undergoing radiotherapy. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Bicher, S. AU - He, W.* AU - Evans, A.C.* AU - Wilson, P.F.* AU - Kuhlman, B.M.* AU - Porada, C.D.* AU - Almeida-Porada, G.* AU - Schmid, T.E.* AU - Coleman, M.A.* C1 - 56242 C2 - 46932 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S165-S165 TI - Biologically inspired nanoparticles as tools for the protection of healthy tissues in radiotherapy. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Borm, K.J.* AU - Duesberg, M.* AU - Oechsner, M.* AU - Mayinger, M.* AU - Buschner, G.* AU - Weber, W.* AU - Combs, S.E. AU - Duma, M.D.* C1 - 56250 C2 - 46939 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S21-S21 TI - The influence of hypofractionation on the incidental irradiation of the axillary lymphatic pathways of patients with breast cancer. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Dapper, H.* AU - Schiller, K.* AU - Muench, S.* AU - Peeken, J.C. AU - Borm, K.J.* AU - Weber, W.* AU - Combs, S.E. C1 - 56258 C2 - 46914 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S9-S9 TI - Have we achieved optimal Recommendations for the Target Volume Definition for Patients with Anal Cancer? A PET-based Analysis of the initial Lymph Node Distribution in Patients with Anal Cancer. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Diehl, C. AU - Shiban, E.* AU - Straube, C. AU - Oechsner, M.* AU - Kessel, C.* AU - Wilkens, J.J.* AU - Wiestler, B.* AU - Zimmer, C.* AU - Meyer, B.* AU - Combs, S.E. C1 - 56259 C2 - 46924 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S117-S117 TI - Neoadjuvant radiotherapy (N-RT) for intracebral metastases of solid tumors (NepoMUC): A phase I dose escalation trial. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Dobiasch, S. AU - Kampfer, S.* AU - Steiger, K.* AU - Schilling, D. AU - Schmid, T.E. AU - Weichert, W.* AU - Wilkens, J.J.* AU - Combs, S.E. C1 - 56254 C2 - 46936 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S172-S172 TI - Histopathological validation of the accuracy of high-precision stereotactic irradiation in an orthotopic pancreatic tumor mouse model. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Eidemüller, M. AU - Holmberg, E.* AU - Lundell, M.* AU - Karlsson, P.* C1 - 56238 C2 - 46928 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S81-S81 TI - Increased risk of breast cancer from radiation in the presence of familial breast cancer history: Results from the Swedish hemangioma cohort and implications for breast cancer radiotherapy. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Fischer, J.C.* AU - Lin, C.-C.* AU - Heidegger, S.* AU - Wintges, A.* AU - Schlapschy, M.* AU - Beudert, M.* AU - Combs, S.E. AU - Bassermann, F.* AU - Skerra, A.* AU - Haas, T.* AU - Poeck, H.* C1 - 56233 C2 - 46922 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S166-S166 TI - No improved Regeneration after radiogenic and immunopathogenic Tissue Damage by Type III Interferon Activation. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Gerhardt, A.S.* AU - Duma, M.N.* AU - Duesberg, M.* AU - Wilkens, J.J.* AU - Combs, S.E. AU - Oechsner, M.* C1 - 56227 C2 - 46911 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S108-S108 TI - Simulation of the Influence of Rotational Errors on the Dose in PTV and Risk Organs during the Storage for cranial Radiotherapy. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Hess J. AU - Unger, K. AU - Maihoefer, C. AU - Schuettrumpf, L. AU - Schneider, L. AU - Heider, T. AU - Weber, P. AU - Marschner, S. AU - Braselmann, H. AU - Kuger, S. AU - Pflugradt, U. AU - Baumeister, P. AU - Walch, A.K. AU - Woischke, C.* AU - Kirchner, T.* AU - Werner, M.* AU - Werner, K.* AU - Baumann, M.* AU - Budach, V.* AU - Combs, S.E. AU - Debus, J.* AU - Grosu, A.-L.* AU - Krause, M.* AU - Roedel, C.* AU - Stuschke, M.* AU - Zips, D.* AU - Zitzelsberger, H. AU - Ganswindt, U. AU - Henke, M.* AU - Belka, C. C1 - 56225 C2 - 46910 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S25-S25 TI - A five-microRNA-signature predicts recurrence and survival in HPV-negative HNSCC. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Kern J.* AU - Saupp, E.* AU - Dobiasch, S. AU - Schilling, D. AU - Stein, M. AU - Hastreiter, S.* AU - Schneider, G.* AU - Schmid, R.M.* AU - Combs, S.E. C1 - 56251 C2 - 46938 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S172-S172 TI - Identification of Biomarkers for the Determination of individual Radiosensitivity in Patients with pancreatic ductal Adenocarcinoma. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Kessel, C. AU - Atkinson, M.J. AU - Schmid, T.E. AU - Trott, K.-R.* AU - Berberat, P.* AU - Combs, S.E. C1 - 56223 C2 - 46909 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S192-S192 TI - A five-year report on the MSc radiation biology at the technical University of Munich (TUM). JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Kessel, K.A. AU - Fischer, H.* AU - Voglhuber, T.* AU - Diehl, C.* AU - Straube, C.* AU - Yakushev, I.* AU - Weber, W.* AU - Zimmer, C.* AU - Combs, S.E. C1 - 56244 C2 - 46944 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S113-S113 TI - Influence of PET imaging during the radiotherapy planning on the survival of meningioma patients. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Kessel, K.A. AU - Gempt, J.* AU - Straube, C.* AU - Meyer, B.* AU - Diehl, C.* AU - Zimmer, C.* AU - Scharl, S.* AU - Combs, S.E. C1 - 56246 C2 - 46943 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S113-S114 TI - Is fractional stereotactic radiation therapy (FSRT) superior to radiosurgery (RC) for the treatment of resection hollow in patients with brain metastases? JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Kessel, K.A. AU - Weber, W.* AU - Zimmer, C.* AU - Meyer, B.* AU - Combs, S.E. C1 - 56247 C2 - 46942 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S34-S34 TI - Development of a prognostic score for the outcome after resection and radiotherapy in patients with high-grade meningioma (WHO II/III). JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Kessler, C.* AU - Reichert, M.* AU - Dobiasch, S. AU - Schilling, D. AU - Dantes, Z.* AU - Stein, M. AU - Grosz, J.* AU - Schmid, R.M.* AU - Combs, S.E. C1 - 56256 C2 - 46949 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S41-S42 TI - Characterization of the radiation response of different patient-derived organoids of pancreatic cancer. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Kirstein, A. AU - Schilling, D. AU - Anastasov, N. AU - Raulefs, S. AU - Combs, S.E. AU - Schmid, T.E. C1 - 56229 C2 - 46918 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S162-S163 TI - Influence of MGMT expression on the radiation response in different Glioblastoma multiforme cell lines. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Klymenko, O. AU - Drexler, G.A. AU - Baumeister, P. AU - Weber, P. AU - Zitzelsberger, H. AU - Unger, K. AU - Hess J. AU - Schoetz, U. AU - Belka, C. AU - Lauber, K. C1 - 56243 C2 - 46933 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S75-S76 TI - Patient-derived HNSCC cell lines and subclones reflect inter- and intra-tumoral heterogeneity regarding genomic copy number alterations and radiation response. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AB - BackgroundMembrane heat shock protein 70 (mHsp70) is indicative of high-risk tumors and serves as atumor-specific target for natural killer (NK) cells stimulated with Hsp70 peptide (TKD) and Interleukin(IL)-2. Radiochemotherapy (RCT), mHsp70-targeting NK cells, and programmed death(PD)-1 inhibition were combined to improve the efficacy of tumor-specific immune cells in anon-small cell lung carcinoma (NSCLC) patient.PatientFollowing simultaneous RCT (64.8Gy), apatient with inoperable NSCLC (cT4, cN3, cM0, stage IIIb) was treated with 4cycles of autologous ex vivo TKD/IL-2-activated NK cells and the PD-1 antibody nivolumab as asecond-line therapy. Blood samples were taken for immunophenotyping during the course of therapy.ResultsAdoptive transfer of ex vivo TKD/IL-2-activated NK cells after RCT combined with PD-1 blockade is well tolerated and results in superior overall survival (OS). No viable tumor cells but amassive immune cell infiltration in fibrotic tissue was detected after therapy. Neither tumor progression nor distant metastases were detectable by CT scanning 33months after diagnosis. Therapy response was associated with significantly increased CD3(-)/NKG2D(+)/CD94(+) NK cell counts, elevated CD8(+) to CD4(+) Tcell and CD3(-)/CD56(bright) to CD3(-)/CD56(dim) NK cell ratios, and significantly reduced regulatory Tcells (Tregs) in the peripheral blood.ConclusionAcombined therapy consisting of RCT, mHsp70-targeting NK cells, and PD-1 antibody inhibition is well tolerated, induces anti-tumor immunity, and results in long-term tumor control in one patient with advanced NSCLC. Further, randomized studies are necessary to confirm the efficacy of this combination therapy. AU - Kokowski, K.* AU - Stangl, S.* AU - Seier, S.* AU - Hildebrandt, M.A.* AU - Vaupel, P.* AU - Multhoff, G. C1 - 55524 C2 - 46380 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 352-361 TI - Radiochemotherapy combined with NK cell transfer followed by second-line PD-1 inhibition in apatient with NSCLC stage IIIb inducing long-term tumor control: Acase study. JO - Strahlenther. Onkol. VL - 195 IS - 4 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Kraus, K.M.* AU - Combs, S.E. C1 - 56766 C2 - 47379 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 1033-1035 TI - Zweitmalignomrisiko nach Behandlung von lokal begrenzten Prostatakarzinomen mit Kohlenstoffionen möglicherweise niedriger als nach Photonenbestrahlung. JO - Strahlenther. Onkol. VL - 195 IS - 11 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Kundrát, P. AU - Simonetto, C. AU - Remmele, J.* AU - Rennau, H.* AU - Sebb, S.* AU - Wolf, U.* AU - Hildebrandt, G.* AU - Eidemüller, M. C1 - 56231 C2 - 46920 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S82-S82 TI - Individual variability in doses to contralateral breast from tangential breast-cancer radiotherapy follows from variations in minimum breast distance. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Nguyen, L. AU - Schilling, D. AU - Dobiasch, S. AU - Schmid, T.E. AU - Combs, S.E. C1 - 56232 C2 - 46921 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S164-S164 TI - Radioresistant pancreatic cancer cell lines show lower levels of reactive oxygen species and higher DNA repair capacity. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Osterode, E.* AU - Schoetz, U.* AU - Orth, M.* AU - Selmansberger, M. AU - Schuster, J.* AU - Hess J. AU - Unger, K. AU - Zitzelsberger, H. AU - Belka, C. AU - Lauber, K. C1 - 56248 C2 - 46941 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S176-S176 TI - Evaluation of CD44v6 targeting strategies in HNSCC. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Peeken, J.C. AU - Molina-Romero, M.* AU - Diehl, C.* AU - Menze, B.H.* AU - Straube, C.* AU - Meyer, B.* AU - Zimmer, C.* AU - Wiestler, B.* AU - Combs, S.E. C1 - 56222 C2 - 46908 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S114-S114 TI - Deep learning derived tumor infiltration maps for personalized target definition in Glioblastoma radiotherapy. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Piehlmaier, D. AU - Stegen, B.* AU - Nieto, A.* AU - Orth, M.* AU - Niyazi, M.* AU - Ruf, V.* AU - Selmansberger, M. AU - Unkel, S.* AU - Hess J. AU - Zitzelsberger, H. AU - Lauber, K. AU - Unger, K. C1 - 56255 C2 - 46935 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S63-S64 TI - In-vitro and in-vivo characterization of a glioblastoma cell line panel. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Sahay, J.* AU - Schilling, D. AU - Combs, S.E. AU - Gehrmann, M.* C1 - 56237 C2 - 46927 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S148-S148 TI - Exosomes from mistletoe extract treated breast cancer cells to stimulate immune cells. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AB - PurposeFor alarge or symptomatic brain metastasis, resection and adjuvant radiotherapy are recommended. Hypofractionated stereotactic radiotherapy (HFSRT) is increasingly applied in patients with alimited number of lesions. Exact target volume definition is critical given the small safety margins. Whilst technical advances have minimized inaccuracy due to patient positioning and radiation targeting, little is known about changes in target volume. This study sought to evaluate potential changes in the resection cavity of abrain metastasis.MethodsIn all, 57patients treated with HFSRT after surgical resection of one brain metastasis between 2008 and 2015 in our institution were included in this study. Gross tumor volume (GTV) of the initial metastasis and the volume of the resection cavity in the post-operative, planning, and follow-up MRIs were measured and compared.ResultsThe mean cavity size decreased after surgery with the greatest change of -23.4% (41.5%) occurring between post-operative MRI and planning MRI (p<0.01). During this time period, the cavity volume decreased, remained stable, and increased in 79.1, 3.5, and 17.4%, respectively. Afurther decrease of -20.7% (58.1%) was perceived between planning MRI and first follow-up (p<0.01). No significant difference in pattern of change could be observed depending on the volume of initial GTV, size of the post-operative resection cavity, initial or post-resection FLAIR (fluid-attenuated inversion recovery) hyper-intensity, postsurgical ischemia, or primary tumor. The resection cavities of patients with post-operative ischemia were significantly larger than resection cavities of patients without ischemia.ConclusionThe resection cavity seems to be very dynamic after surgery. Hence, it remains necessary to use very recent scans for treatment planning. AU - Scharl, S.* AU - Kirstein, A. AU - Kessel, K.A. AU - Duma, M.N. AU - Oechsner, M.* AU - Straube, C.* AU - Combs, S.E. C1 - 54712 C2 - 45776 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 207-217 TI - Cavity volume changes after surgery of abrain metastasisconsequences for stereotactic radiation therapy. JO - Strahlenther. Onkol. VL - 195 IS - 3 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Schilling, D. AU - Wank, M. AU - Reindl, J.* AU - Schmid, T.E. AU - Combs, S.E. C1 - 56220 C2 - 46907 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S90-S90 TI - Development of a cell culture system for irradiation with high LET alpha particles under hypoxic conditions. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Schmal, Z.* AU - Isermann, A.* AU - Hladik, D. AU - von Toerne, C. AU - Tapio, S. AU - Ruebe, C.E.* C1 - 56230 C2 - 46919 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S90-S90 TI - DNA damage accumulation during fractionated low-dose radiation compromises hippocampal neurogenesis. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Schmid, T.E. AU - Hellmundt, F. AU - Lemmer, S.* AU - Ilicic, K. AU - Melzner, M.* AU - Bartzsch, S. AU - Scherthan, H.* AU - Wilkens, J.J.* AU - Combs, S.E. C1 - 56217 C2 - 46917 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S89-S89 TI - Biological interaction of ionizing irradiation with a static magnetic field (SMF). JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Schnoeller, L.* AU - Fleischmann, D.F.* AU - Brix, N.* AU - Orth, M.* AU - Nieto, A.* AU - Unger, K. AU - Belka, C. AU - Zitzelsberger, H. AU - Lauber, K. C1 - 56219 C2 - 46915 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S120-S121 TI - In-depth characterization of radiation response in a human glioblastoma cell line panel. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Schötz, U. AU - Shnayien, S.* AU - Spoel, S.* AU - Kinzel, L.* AU - Maihöfer, C. AU - Hess J. AU - Zitzelsberger, H. AU - Klein, D.* AU - Jendrossek, V.* AU - Klinger, B.* AU - Sieber, A.* AU - Bluehgen, N.* AU - Belka, C. AU - Unkel, S.* AU - Lauber, K. C1 - 56241 C2 - 46931 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S76-S76 TI - Inherent resistance of head and neck tumors: Cellular senescence and associated cyokine production as key mechanisms in vitro and in vivo. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Schrickel, F. AU - Wank, M. AU - Meyer, B.* AU - Gempt, J.* AU - Barz, M.* AU - Schmid, T.E. AU - Combs, S.E. AU - Schilling, D. C1 - 56240 C2 - 46930 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S168-S169 TI - The individual invasive properties of patient-derived primary GBM cells. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Siegmann, A. AU - Hunger, A. AU - Steel, H.* AU - Weigel, J. AU - Pellicioli, P.* AU - Nguyen, M. AU - Treibel, F. AU - Bicher, S. AU - Hombrink, G.* AU - Requardt, H.* AU - Combs, S.E. AU - Bartzsch, S. AU - Schmid, T.E. C1 - 56234 C2 - 46923 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S174-S175 TI - New insights into dose-rate effects (FLASH) on clonogenic cell survival of tumor and normal cell lines. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Simonetto, C. AU - Mayinger, M.* AU - Borm, K.J.* AU - Ahmed, T.* AU - Pigorsch, S.U.* AU - Kaiser, C. AU - Combs, S.E. C1 - 56218 C2 - 46916 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S128-S128 TI - Longitudinal atherosclerotic changes in patients with hypopharyngeal carcinoma after radio (Chemo) therapy. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Straube, C. AU - Shiban, E.* AU - Meyer, B.* AU - Combs, S.E. C1 - 55916 C2 - 47176 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 688-690 TI - Radiochirurgie und operative neurovaskuläre Dekompression annähernd gleichwertig beider Behandlung von Trigeminusneuralgien. JO - Strahlenther. Onkol. VL - 195 IS - 7 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Unger, K. AU - Fleischmann, D.F.* AU - Ruf, V.* AU - Felsberg, J.* AU - Piehlmaier, D. AU - Hess J. AU - Mittelbronn, M.* AU - Lauber, K. AU - Budach, W.* AU - Roedel, C.* AU - Säbel, M.* AU - Reifenberger, G.* AU - Herms, J.* AU - Zitzelsberger, H. AU - Belka, C. AU - Niyazi, M.* C1 - 56239 C2 - 46929 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S63-S63 TI - Validation of a 4-miRNA prognosticator allowing for improved risk stratification of glioblastoma patients in combination with MGMT promoter methylation status. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AB - PurposeThe present study aims to evaluate both early and late toxicity profiles of patients receiving immediate postoperative radiotherapy (RT; adjuvant RT or additive RT) compared to salvage RT.MethodsWe evaluated 253patients with prostate cancer treated with either immediate postoperative (adjuvant RT, n=42; additive RT, n=39) or salvage RT (n=137). Thirty-five patients received salvage treatment but did not achieve apostoperative prostate specific antigen (PSA) level <0.1ng/ml and thus were excluded from analysis.ResultsAsignificantly higher rate of early grade1/2 proctitis in the immediate postoperative RT group without additional pelvic RT was observed (p=0.02). Patients in the immediate postoperative RT group without additional pelvic RT showed significantly more early urinary tract obstructions (p=0.003). Toxicity rates of early (<3months) and late (3-6months) postoperative RT were similar (p>0.05). Baseline recovery rate of erectile dysfunction was better in patients with immediate postoperative RT without additional pelvic RT (p=0.02; hazard ratio (HR)=2.22, 95%-confidence interval, 95%-CI: 1.12-4.37). Recovery rate of urinary incontinence showed no significant difference in all groups (p>0.05).ConclusionPatients receiving immediate postoperative RT (adjuvant or additive RT) without additional pelvic RT experience early gastrointestinal (GI) side effect proctitis and, as well as early genitourinary (GU) toxicity urinary tract obstruction more frequently than patients treated with salvage RT. Therefore, complete recovery after surgery is essential. However, we suggest basing the treatment decision on the patient's postoperative clinical condition and evaluation of any adverse risk factors, since many studies demonstrate aclear benefit for immediate postoperative RT (adjuvant or additive RT) in terms of oncological outcome. ZusammenfassungHintergrundIn der vorliegenden Auswertung werden die fruhen und spaten Nebenwirkungen der sofortigen postoperativen Radiotherapie (RT; adjuvante oder additive RT) mit der Salvage-RT verglichen.MethodenDie Autoren werteten die Daten von 253Patienten mit Prostatakarzinom aus, welche mit sofortiger postoperativer RT behandelt wurden: n=42 fur adjuvante RT, n=39 fur additive RT, n=137 fur Salvage-RT. Die 35mit einer Salvage-Therapie behandelten Patienten, die keinen postoperativen Nadir fur das prostataspezifische Antigen (PSA) <0,1ng/ml erreichten, wurden aus der Analyse ausgeschlossen.ErgebnissePatienten mit sofortiger postoperativer RT ohne zusatzliche RT des Beckens zeigten eine signifikant hohere Rate an fruhen Grad-1/2-Proktitiden (p=0,02). Au ss erdem wies diese Gruppe signifikant mehr fruhe obstruktive Uropathien auf (p=0,003). Es gab keinen signifikanten Unterschied (p>0,05) bezuglich der Nebenwirkungsprofile zwischen Patienten mit fruher postoperativer RT (innerhalb <3Monate) vs. spate postoperative RT (innerhalb von 3-6Monaten). Die Post-RT-Ruckbildungsrate der erektilen Dysfunktion war signifikant besser bei Patienten mit sofortiger postoperativer RT ohne zusatzliche RT des Beckens (p=0,02; Hazard Ratio, HR=2,22; 95%-Konfidenzintervall, 95%-KI: 1.12-4,37). Dagegen wies die Ruckbildungsrate einer Harninkontinenz keine signifikanten Unterschiede in allen Gruppen auf (p>0,05).SchlussfolgerungBei Patienten mit sofortiger postoperativer RT (adjuvante oder additive RT) ohne zusatzliche RT des Beckens treten haufiger fruhe gastrointestinale Nebenwirkungen wie Proktitis auf. Ebenso leiden sie haufiger an obstruktiven Uropathien.Eine komplette postoperative Erholung von Nebenwirkungen ist deswegen wichtig. Die Autoren empfehlen daher, die Therapieentscheidung mit Blick auf den postoperativen Zustand des Patienten und vorhandene Risikofaktoren fur ein Rezidiv zu treffen, denn manche Tumorfaktoren machen eine aggressive Vorgehensweise notwendig. AU - Vogel, M.M. AU - Kessel, K.A. AU - Gschwend, J.E.* AU - Weichert, W.* AU - Wilkens, J.J.* AU - Combs, S.E. C1 - 54310 C2 - 45458 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 131-144 TI - Early and late toxicity profiles of patients receiving immediate postoperative radiotherapy versus salvage radiotherapy for prostate cancer after prostatectomy. JO - Strahlenther. Onkol. VL - 195 IS - 2 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Vogel, M.M.E.* AU - Kroeze, S.G.C.* AU - Henkenberens, C.* AU - Schmidt-Hegemann, N.-S.* AU - Kirste, S.* AU - Becker, J.* AU - Christiansen, H.* AU - Belka, C.* AU - Grosu, A.-L.* AU - Müller, A.-C.* AU - Guckenberger, M.* AU - Combs, S.E. C1 - 56253 C2 - 46937 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S30-S31 TI - Development of a prognostic Risk Classification for biochemical Recurrence after PSMA-PET-based Radiotherapy in Patients with oligometastatic Prostate Cancer. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Voglhuber, T.* AU - Kessel, K.A. AU - Oechsner, M.* AU - Combs, S.E. C1 - 56249 C2 - 46940 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S39-S39 TI - Patterns of care and outcome analysis of stereotactic radiotherapy for patients with adrenal metastases. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AB - Background The goal of this study was to investigate if daily dose recalculations are necessary or if less time-consuming approaches can be used to identify dose differences to the planned dose in patients with head and neck cancers (H&N).Methods For 12H&N patients treated with helical tomotherapy, daily dose calculations were performed retrospectively. Four different summation doses (SuDo) were calculated: DayDo (daily dose calculation), MVCTx2, MVCTx5, and MVCTx10 (dose calculations every second, fifth, and tenth fraction). Dose recalculations were depicted on the last contoured mega voltage CT (MVCT). The DayDo was compared to the planned dose and to the less time-consuming SuDo scenarios. The doses were assessed for the planning target volume (PTV) and the organs at risk (OARs): mandible (mand), spinal cord (SC), spinal cord +5mm (SC+5mm), parotid glands (PG).Results The ipsilateral PG, contralateral PG, and PTV volume decreased by -22.5% (range: -34.8 to 5.2%), -19.5% (-31.5 to 15.8%), and -2.6% (-16.7 to 0.2%), respectively. There was asignificant median mean dose (Dmean) dose difference for DayDo compared to the planned dose for PG total of 1.9 Gy (-3.3 to 7.3 Gy). But less time-consuming SuDo compared to DayDo showed statistically significant but not clinically relevant (<2%) dose differences for several organs. Hence the small dose difference to the gold standard (DayDo), we recommend dose recalculations every fifth MVCT in order to identify the occurrence of dose differences compared to the planned dose.Conclusion Daily dose calculations are the most precise to assess dose differences between actual and planned dose. Dose recalculations on every fifth MVCT (i.e., weekly control CTs) are an applicable and time-saving way of identifying patients with significant dose differences compared to the planned dose. AU - Wagenblast, S.* AU - Kampfer, S.* AU - Borm, K.J.* AU - Combs, S.E. AU - Pigorsch, S.U.* AU - Duma, M.N. C1 - 54961 C2 - 45996 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 475-481 TI - CT-based dose recalculations in head and neck cancer radiotherapy: Comparison of daily dose recalculations to less time-consuming approaches. JO - Strahlenther. Onkol. VL - 195 IS - 6 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Waltenberger, M.* AU - Kessel, K.A. AU - Peeken, J.C. AU - Weber, W.* AU - Pyka, T.* AU - Zimmer, C.* AU - Combs, S.E. C1 - 56235 C2 - 46925 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S115-S115 TI - 18F-FET PET MRI / CT in glioblastoma Rrlapse - contribution to target volume definition and association of tracer uptakes with survival. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AU - Wintergerst, L. AU - Selmansberger, M. AU - Maihoefer, C. AU - Schuettrumpf, L. AU - Walch, A.K. AU - Wilke, C. AU - Pitea, A. AU - Woischke, C.* AU - Baumeister, P. AU - Kirchner, T.* AU - Belka, C. AU - Ganswindt, U. AU - Zitzelsberger, H. AU - Unger, K. AU - Hess J. C1 - 56245 C2 - 46945 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - S24-S25 TI - A 16q24.3 4-gene mRNA signature predicts outcome in radio(chemo)therapy-treated head and neck squamous cell carcinoma. JO - Strahlenther. Onkol. VL - 195 PB - Springer Heidelberg PY - 2019 SN - 0179-7158 ER - TY - JOUR AB - Purpose: The aim of this study was to evaluate prognostic factors in patients with lung metastases who undergo lung stereotactic body radiotherapy (SBRT). Materials and methods: A total of 87 patients with 129 lung metastases who underwent SBRT between November 2004 and May 2012 were enrolled in this retrospective study. The patient collective consisted of 54 men (62.1%) and 33 women (37.9%); the median age was 65 years (range 36–88). The Karnofsky performance index was ≥70% (median 90%) for all cases, but one (60%). Adverse effects were categorized using the CTCAE 4.0 classification system. Retrospective analyses regarding patients’ characteristics, progression-free survival (PFS), overall survival (OS), disease-specific survival (DSS), and local tumor control rates (LTC) were performed. Results: On univariate and multivariate analysis OS, DSS, and PFS were significantly (p?< 0.05) better for patients with ≤3 lung metastases; no extrathoracic metastases at the time of the SBRT; a gross tumor volume (GTV) <7.7?cm3and patients that received a staging that included positron emission tomography with fluorine 18 fluorodeoxyglucose/computed tomography (FDG-PET/CT) imaging. Furthermore, a longer OS was observed if newly diagnosed metastases during follow-up were limited to the lung (median survival: 43.7 months versus 21.7 months; p?= 0.023). Conclusion: The number and pattern of metastases, and the size of the target volume are strong predictors for the outcome of patients receiving SBRT of lung tumors. FDG-PET/CT should be part of pretherapeutic staging before SBRT. AU - Borm, K.J.* AU - Oechsner, M.* AU - Schiller, K.* AU - Peeken, J.C.* AU - Dapper, H.* AU - Münch, S.* AU - Kroll, L.E.* AU - Combs, S.E. AU - Duma, M.N. C1 - 53988 C2 - 45183 SP - 886-893 TI - Prognostic factors in stereotactic body radiotherapy of lung metastases. JO - Strahlenther. Onkol. VL - 194 IS - 10 PY - 2018 SN - 0179-7158 ER - TY - JOUR AU - Diehl, D.* AU - Münch, S.* AU - Müller, B.S.* AU - Borm, K.J.* AU - Ryang, Y.M.* AU - Combs, S.E. AU - Duma, M.N.* C1 - 54727 C2 - 45783 TI - Adjuvant radiation after spinal instrumentation in metastatic bone disease: The potential benefit of carbon pedicel screws in target delineation in RT treatment planning . JO - Strahlenther. Onkol. VL - 194 PY - 2018 SN - 0179-7158 ER - TY - JOUR AB - Pancreatic cancer is one of the most aggressive human tumors and the incidence has increased over the last 6 years. In the majority of cases the disease is already in an advanced stage at the time of diagnosis where surgery, the only curative treatment, is no longer an option and explains the still abysmal overall survival. The role of radiation therapy as treatment option for patients with pancreatic cancer is controversially discussed although radiation oncology has emerged as a central pillar in the combined oncological treatment. The present manuscript gives an overview of advanced radiotherapeutic strategies in the context of chemotherapy and surgery according to the current American Society of Clinical Oncology (ASCO) guidelines in comparison with the German guidelines and to elucidate the role of radiation therapy for the treatment of pancreatic cancer. Advanced modern radiotherapeutic techniques in combination with individualized high-precision radiation concepts are new therapeutic approaches for pancreatic cancer in a multimodal setting with tolerable side effects. Several clinical studies together with experimental approaches are in process, to deliver further evidence and ultimately allow true personalized medicine. AU - Dobiasch, S.* AU - Goerig, N.L.* AU - Fietkau, R.* AU - Combs, S.E. C1 - 52328 C2 - 43880 CY - Heidelberg SP - 185–195 TI - Essential role of radiation therapy for the treatment of pancreatic cancer. JO - Strahlenther. Onkol. VL - 194 IS - 3 PB - Springer Heidelberg PY - 2018 SN - 0179-7158 ER - TY - JOUR AB - Background and purpose: Recently, imaging and high-precision irradiation devices for preclinical tumor models have been developed. Image-guided radiation therapy (IGRT) including innovative treatment planning techniques comparable to patient treatment can be achieved in a translational context. The study aims to evaluate magnetic resonance imaging/computed tomography (MRI/CT)-based treatment planning with different treatment techniques for high-precision radiation therapy (RT). Materials and methods: In an orthotopic pancreatic cancer model, MRI/CT-based radiation treatment planning was established. Three irradiation techniques (rotational, 3D multifield, stereotactic) were performed with the SARRP system (Small Animal Radiation Research Platform, Xstrahl Ltd., Camberley, UK). Dose distributions in gross tumor volume (GTV) and organs at risk (OAR) were analyzed for each treatment setting. Results: MRI with high soft tissue contrast improved imaging of GTV and OARs. Therefore MRI-based treatment planning enables precise contouring of GTV and OARs, thus, providing a perfect basis for an improved dose distribution and coverage of the GTV for all advanced radiation techniques. Conclusion: An MRI/CT-based treatment planning for high-precision IGRT using different techniques was established in an orthotopic pancreatic tumor model. Advanced radiation techniques allow considering perfect coverage of GTV and sparing of OARs in the preclinical setting and reflect clinical treatment plans of pancreatic cancer patients. AU - Dobiasch, S. AU - Kampfer, S.* AU - Habermehl, D. AU - Duma, M.N.* AU - Felix, K.* AU - Strauss, A.* AU - Schilling, D. AU - Wilkens, J.J.* AU - Combs, S.E. C1 - 53710 C2 - 44982 SP - 994-952 TI - MRI-based high-precision irradiation in an orthotopic pancreatic tumor mouse model: A treatment planning study. JO - Strahlenther. Onkol. VL - 194 IS - 10 PY - 2018 SN - 0179-7158 ER - TY - JOUR AU - Issels, R.* AU - Lindner, L.* AU - Buecklein, V.* AU - Multhoff, G.* AU - Salat, C.* AU - von Bergwelt, M.* AU - Nößner, E. C1 - 53498 C2 - 44677 SP - 483-484 TI - Regional hyperthermia and immuno-oncology. JO - Strahlenther. Onkol. VL - 194 IS - 5 PY - 2018 SN - 0179-7158 ER - TY - JOUR AB - Introduction: Recently, complementary and alternative medicine (CAM) has moved more into the focus, and cancer societies such as the German Cancer Society (Deutsche Krebsgesellschaft, DKG) have established working groups to develop a guideline for CAM. The present work aims to evaluate the acceptance of CAM in the whole radiation oncology community. Methods: We conducted an online survey on CAM and sent the modified questionnaire that was successfully distributed to all members of the Research Group on Gynecological Oncology (Arbeitsgemeinschaft Gynakologische Onkologie, AGO) of the DKG in 2014 to the members of the German Society of Radiation Oncology (Deutsche Gesellschaft für Radioonkologie und Strahlentherapie, DEGRO). The survey consisted of 17 questions regarding personal information and current CAM guidelines within the workplace/clinic. Results: A total of 143 members participated. Of these, 12% had some CAM qualification. For hematological cancer in 35% and in up to 76% for breast cancer, CAM treatment is offered in German radiation oncology facilities, mainly due to fatigue symptoms. CAM is part of routine treatment in 32.2%, 22.0% are planning to incorporate it. Most physicians advise patients to partake in sports activities and recommend dietary supplements and nutritional counseling. The cost of CAM treatment is fully covered in 9.8% of all participating facilities. Conclusion: Today, CAM is integrated into cancer care; however, skepticism regarding its effect still exists. Evidence-based results must be generated to convince physicians of the effectiveness of CAM methods. CAM qualifications must be included in physicians’ training to improve their understanding and counseling regarding CAM options in cancer care. AU - Kessel, K.A. AU - Klein, E.K.* AU - Hack, C.C.* AU - Combs, S.E. C1 - 54134 C2 - 45369 SP - 904-910 TI - Complementary medicine in radiation oncology: German health care professionals’ current qualifications and therapeutic methods. JO - Strahlenther. Onkol. VL - 194 IS - 10 PY - 2018 SN - 0179-7158 ER - TY - JOUR AB - To date, it remains unclear whether locally advanced adenocarcinoma of the gastroesophageal junction (AEG) should be treated with neoadjuvant chemoradiation (nCRT), analogous to esophageal cancer, or with perioperative chemotherapy (pCT), analogous to gastric cancer. The purpose of this study was to analyze the data of the Munich Cancer Registry (MCR) and to compare pCT and nCRT in AEG patients. A total of 2,992 AEG patients, treated between 1998 and 2014, were included in the study. Baseline and tumor parameters as well as overall survival (OS) and tumor recurrence were compared between 56 patients undergoing nCRT and 64 patients undergoing pCT with UICC stage II/III cancer. In addition, uni- and multivariate analyses using Cox regression models were performed to evaluate the effect of tumor characteristics and treatment regimens on OS. In patients with UICC stage II/III AEG treated with either nCRT or pCT, no significant differences were seen for baseline and tumor characteristics. While there was a significantly higher cumulative incidence of locoregional treatment failure after pCT (32.8%; 95% CI: 18.0-48.4%) compared with nCRT (7.4%; 95% CI: 2.3-16.5%; p = 0.007), there was no significant difference for distant treatment failure (52.9%; 95% CI: 35.4-67.7% and 38.4%; 95% CI: 23.7-52.9%; p = 0.347). When analyzing the whole cohort, patients who received pCT were younger (58.3 years vs. 63.0 years; p = 0.016), had a higher chance of complete tumor resection (81% vs. 67%; p = 0.033), more resected lymph nodes (p = 0.036), and fewer lymph node metastases (p = 0.038) compared with patients who received nCRT. Nevertheless, there was still a strong trend toward a higher incidence of local treatment failure after pCT (25.8%; 95% CI: 14.7-38.3% vs. 12.6%; 95% CI: 5.5-22.8%; p = 0.053). Comparable to the results for patients with UICC stage II/III, no difference was seen for the incidence of distant treatment failure. When excluding patients with UICC stage IV cancer, no significant difference was found for OS. For UICC stage II/III carcinoma, nCRT was associated with an improved locoregional tumor control compared with pCT, while no further significant differences were seen between nCRT and pCT for UICC stage II/III AEG. Moreover, there was a strong trend toward improved locoregional tumor control after nCRT when analyzing all patients treated with nCRT or pCT, despite these patients having higher risk factors. AU - Münch, S.* AU - Habermehl, D. AU - Agha, A.* AU - Belka, C.* AU - Combs, S.E. AU - Eckel, R.H.* AU - Friess, H.* AU - Gerbes, A.L.* AU - Nüssler, N.C.* AU - Schepp, W.* AU - Schmid, R.M.* AU - Schmitt, W.* AU - Schubert-Fritschle, G.* AU - Weber, B.* AU - Werner, J.* AU - Engel, J.* C1 - 52263 C2 - 43851 CY - Heidelberg SP - 125-135 TI - Perioperative chemotherapy vs. neoadjuvant chemoradiation in gastroesophageal junction adenocarcinoma. A population-based evaluation of the Munich Cancer Registry. JO - Strahlenther. Onkol. VL - 194 IS - 2 PB - Springer Heidelberg PY - 2018 SN - 0179-7158 ER - TY - JOUR AB - Skin affections after sulfur mustard (SM) exposure include erythema, blister formation and severe inflammation. An antidote or specific therapy does not exist. Anti-inflammatory compounds as well as substances counteracting SM-induced cell death are under investigation. In this study, we investigated the benzylisoquinoline alkaloide berberine (BER), a metabolite in plants like berberis vulgaris, which is used as herbal pharmaceutical in Asian countries, against SM toxicity using a well-established in vitro approach. Keratinocyte (HaCaT) mono-cultures (MoC) or HaCaT/THP-1 co-cultures (CoC) were challenged with 100, 200 or 300 mM SM for 1 h. Post-exposure, both MoC and CoC were treated with 10, 30 or 50 mu M BER for 24 h. At that time, supernatants were collected and analyzed both for interleukine (IL) 6 and 8 levels and for content of adenylate-kinase (AK) as surrogate marker for cell necrosis. Cells were lysed and nucleosome formation as marker for late apoptosis was assessed. In parallel, AK in cells was determined for normalization purposes. BER treatment did not influence necrosis, but significantly decreased apoptosis. Anti-inflammatory effects were moderate, but also significant, primarily in CoC. Overall, BER has protective effects against SM toxicity in vitro. Whether this holds true should be evaluated in future in vivo studies. AU - Peeken, J.C.* AU - Hesse, J.* AU - Haller, B.* AU - Kessel, K.A.* AU - Nüsslin, F.* AU - Combs, S.E. C1 - 52989 C2 - 44692 CY - Elsevier House, Brookvale Plaza, East Park Shannon, Co, Clare, 00000, Ireland SP - 580-590 TI - Semantic imaging features predict disease progression and survival in glioblastoma multiforme patients. JO - Strahlenther. Onkol. VL - 194 IS - 6 PB - Elsevier Ireland Ltd PY - 2018 SN - 0179-7158 ER - TY - JOUR AB - Current prognostic models for soft tissue sarcoma (STS) patients are solely based on staging information. Treatment-related data have not been included to date. Including such information, however, could help to improve these models.A single-center retrospective cohort of 136 STS patients treated with radiotherapy (RT) was analyzed for patients' characteristics, staging information, and treatment-related data. Therapeutic imaging studies and pathology reports of neoadjuvantly treated patients were analyzed for signs of response. Random forest machine learning-based models were used to predict patients' death and disease progression at 2 years. Pre-treatment and treatment models were compared.The prognostic models achieved high performances. Using treatment features improved the overall performance for all three classification types: prediction of death, and of local and systemic progression (area under the receiver operatoring characteristic curve (AUC) of 0.87, 0.88, and 0.84, respectively). Overall, RT-related features, such as the planning target volume and total dose, had preeminent importance for prognostic performance. Therapy response features were selected for prediction of disease progression.A machine learning-based prognostic model combining known prognostic factors with treatment- and response-related information showed high accuracy for individualized risk assessment. This model could be used for adjustments of follow-up procedures. AU - Peeken, J.C.* AU - Goldberg, T.* AU - Knie, C.* AU - Komboz, B.* AU - Bernhofer, M.* AU - Pasa, F.* AU - Kessel, K.A. AU - Tafti, P.D.* AU - Rost, B.* AU - Nüsslin, F.* AU - Braun, A.E.* AU - Combs, S.E. C1 - 53890 C2 - 45124 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 824-834 TI - Treatment-related features improve machine learning prediction of prognosis in soft tissue sarcoma patients. JO - Strahlenther. Onkol. VL - 194 IS - 9 PB - Springer Heidelberg PY - 2018 SN - 0179-7158 ER - TY - JOUR AB - Ziel der Arbeit Vergleich von alternativen Behandlungsmethoden mit etablierten konventionellen Therapien bezüglich des Überlebens. Patientengut und Methoden Die Autoren bedienen sich der National Cancer Database, um Patienten mit Brust‑, Prostata- und Lungenkrebs oder kolorektalen Karzinomen zu identifizieren, die keine konventionellen Krebstherapien im Zeitraum von 2004 bis 2013 wahrgenommen haben, um „alternative Behandlungen von ‚nichtmedizinischem Fachpersonal‘ durchführen zu lassen“. Ausschlusskriterien beinhalteten u. a. metastasierte Stadien sowie ein Stadium IV (nach AJCC) oder wenn Patienten vorab Therapien in palliativer Intention erhalten hatten. Die Patientengruppe, die mit alternativen Methoden behandelt wurde (280 Patienten), wurde 1:2 nach klinischen Merkmalen gepaart mit Patienten, die sich für konventionelle Behandlungsmethoden entschieden hatten. Ergebnisse Patienten, die einen alternativen Therapieansatz gegenüber konventionellen Krebstherapien vorzogen, waren bevorzugt jünger, weiblich, mit weniger Komorbiditäten, hatten ein höheres Tumorstadium, ein höheres Einkommen und eine höhere Bildung. Gehäuft präferierten Brustkrebspatientinnen oder Lungenkrebspatienten alternative Heilverfahren. Nach einer mittleren Nachbeobachtungszeit von 66 Monaten waren die Patienten, die lediglich mit alternativen Methoden behandelt wurden, mit einem schlechteren 5‑Jahres-Überleben vergesellschaftet. Stratifiziert galt dies für alle untersuchten Tumorentitäten bis auf das Prostatakarzinom; hier konnte kein schlechteres Gesamtüberleben detektiert werden. Der größte Unterschied konnte für Brustkrebspatientinnen festgestellt werden, die sich schon zu Beginn ihrer Erkrankung exklusiv für alternative Therapien entschieden hatten. Diese Gruppe hatte ein 5‑fach erhöhtes Sterberisiko (kolorektales Karzinom 4‑fach und Lungenkrebs 2‑fach erhöht). Schlussfolgerung der Autoren Vor der Wahl von alternativen Behandlungsmethoden als primäre Krebstherapie gilt es, diese kritischer zu hinterfragen.   AU - Schiller, K.* AU - Combs, S.E. C1 - 54215 C2 - 45340 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 870-871 TI - Einsatz alternativer Behandlungsmethoden bei Krebserkrankungen und Auswirkungen auf das Überleben. JO - Strahlenther. Onkol. VL - 194 IS - 9 PB - Springer Heidelberg PY - 2018 SN - 0179-7158 ER - TY - JOUR AB - PurposeWith the ever-increasing cure rates in breast cancer, radiotherapy-induced cancers have become an important issue. This study aimed to estimate secondary cancer risks for different treatment techniques, taking into account organs throughout the body.Material and methodsOrgan doses were evaluated for atangential three-dimensional conformal (3D-CRT) and amulti-field intensity-modulated radiotherapy (IMRT) plan using avalidated, Monte Carlo-based treatment planning system. Effects of wedges and of forward versus inverse planning were systematically investigated on the basis of phantom measurements. Organ-specific cancer risks were estimated using risk coefficients derived from radiotherapy patients or from the atomic bomb survivors.ResultsIn the 3D-CRT plan, mean organ doses could be kept below 1Gy for more remote organs than the lung, heart, and contralateral breast, and decreased to afew cGy for organs in the lower torso. Multi-field IMRT led to considerably higher mean doses in organs at risk, the difference being higher than 50% for many organs. Likewise, the peripheral radiation burden was increased by external wedges. No difference was observed for forward versus inverse planning. Despite the lower doses, the total estimated secondary cancer risk in more remote organs was comparable to that in the lung or the contralateral breast. For multi-field IMRT it was 75% higher than for 3D-CRT without external wedges.ConclusionRemote organs are important for assessment of radiation-induced cancer risk. Remote doses can be reduced effectively by application of atangential field configuration and alinear accelerator set-up with low head scatter radiation. AU - Simonetto, C. AU - Rennau, H.* AU - Remmele, J.* AU - Sebb, S.* AU - Kundrat, P. AU - Eidemüller, M. AU - Wolf, U.* AU - Hildebrandt, G.* C1 - 54576 C2 - 45677 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 32-42 TI - Exposure of remote organs and associated cancer risks from tangential and multi-field breast cancer radiotherapy. JO - Strahlenther. Onkol. VL - 195 IS - 1 PB - Springer Heidelberg PY - 2018 SN - 0179-7158 ER - TY - JOUR AU - Arend, F.* AU - Duma, M.N. AU - Combs, S.E. AU - Oechsner, M.* C1 - 52615 C2 - 44358 CY - Heidelberg SP - S164-S164 TI - Volume regression of cervical carcinoma in T2-weighted MRI under percutaneous radio-chemotherapy. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Asadpour, R.* AU - Kessel, K.A. AU - Habermehl, D. AU - Bruckner, T.* AU - Sertel, S.* AU - Combs, S.E. C1 - 52616 C2 - 44123 CY - Heidelberg SP - S172-S173 TI - Randomized study exploring the combination of radioTherapy with two types of acupuncture treatment (ROSETTA trial). JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Bihoi, G.A.* AU - Kessel, K.A. AU - Oechsner, M.* AU - Duma, M.N.* AU - Combs, S.E. C1 - 52630 C2 - 44418 CY - Heidelberg SP - S133-S134 TI - Influence of the dose applied to the cochlea during radiotherapy of the vestibular schwannoma and its effect on hearing preservation. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Burger, K.* AU - Ilicic, K.* AU - Dombrowsky, A. AU - Dierolf, M.* AU - Guenther, B.* AU - Schmid, E.* AU - Walsh, D.W.M.* AU - Urban, T.* AU - Bartzsch, S.* AU - Radtke, A.* AU - Eggl, E.* AU - Achterhold, K.* AU - Gleich, B.* AU - Combs, S.E. AU - Molls, M.M.* AU - Schmid, T.E. AU - Pfeiffer, F.* AU - Wilkens, J.J. C1 - 52649 C2 - 44454 CY - Heidelberg SP - S10-S11 TI - Micro-channel radiotherapy with X-rays on a compact synchrotron. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Combs, S.E. AU - Kessel, C.* AU - Trott, K.R.* AU - Berberat, P.* AU - Atkinson, M.J. C1 - 52632 C2 - 44416 CY - Heidelberg SP - S116-S116 TI - Students' expectations regarding work load, teaching format and interprofessional acitivies in an International Master of Science (MSc) course in radiation biology. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Combs, S.E. AU - Kessel, K.* AU - Hesse, J.* AU - Straube, C.* AU - Schmidt-Graf, F.* AU - Zimmer, C.* AU - Gempt, J.* AU - Meyer, B.* C1 - 52640 C2 - 44409 CY - Heidelberg SP - S52-S53 TI - Moving second courses of radiotherapy forward: early re-irradiation after surgical resection for recurrent gliomas improves efficacy with excellent tolerability. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AB - Modern breast cancer radiotherapy techniques, such as respiratory-gated radiotherapy in deep-inspiration breath-hold (DIBH) or volumetric-modulated arc radiotherapy (VMAT) have been shown to reduce the high dose exposure of the heart in left-sided breast cancer. The aim of the present study was to comparatively estimate the excess relative and absolute risks of radiation-induced secondary lung cancer and ischemic heart disease for different modern radiotherapy techniques. Four different treatment plans were generated for ten computed tomography data sets of patients with left-sided breast cancer, using either three-dimensional conformal radiotherapy (3D-CRT) or VMAT, in free-breathing (FB) or DIBH. Dose-volume histograms were used for organ equivalent dose (OED) calculations using linear, linear-exponential, and plateau models for the lung. A linear model was applied to estimate the long-term risk of ischemic heart disease as motivated by epidemiologic data. Excess relative risk (ERR) and 10-year excess absolute risk (EAR) for radiation-induced secondary lung cancer and ischemic heart disease were estimated for different representative baseline risks. The DIBH maneuver resulted in a significant reduction of the ERR and estimated 10-year excess absolute risk for major coronary events compared to FB in 3D-CRT plans (p = 0.04). In VMAT plans, the mean predicted risk reduction through DIBH was less pronounced and not statistically significant (p = 0.44). The risk of radiation-induced secondary lung cancer was mainly influenced by the radiotherapy technique, with no beneficial effect through DIBH. VMAT plans correlated with an increase in 10-year EAR for radiation-induced lung cancer as compared to 3D-CRT plans (DIBH p = 0.007; FB p = 0.005, respectively). However, the EARs were affected more strongly by nonradiation-associated risk factors, such as smoking, as compared to the choice of treatment technique. The results indicate that 3D-CRT plans in DIBH pose the lowest risk for both major coronary events and secondary lung cancer. AU - Corradini, S.* AU - Ballhausen, H.* AU - Weingandt, H.* AU - Freislederer, P.* AU - Schönecker, S.* AU - Niyazi, M.* AU - Simonetto, C. AU - Eidemüller, M. AU - Ganswindt, U.* AU - Belka, C.* C1 - 51901 C2 - 43562 CY - Heidelberg SP - 196-205 TI - Left-sided breast cancer and risks of secondary lung cancer and ischemic heart disease. JO - Strahlenther. Onkol. VL - 194 IS - 3 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AB - Correction to: Strahlenther Onkol 2017 https://doi.org/10.1007/s00066-017-1213-y Unfortunately, during copy editing, the titles of Fig. 2a and 2b were removed. The correct Fig. 2a and 2b are shown below. The original article has been corrected aEuro broken vertical bar. AU - Corradini, S.* AU - Ballhausen, H.* AU - Weingandt, H.* AU - Freislederer, P.* AU - Schönecker, S.* AU - Niyazi, M.* AU - Simonetto, C. AU - Eidemüller, M. AU - Ganswindt, U.* AU - Belka, C.* C1 - 52267 C2 - 43888 CY - Heidelberg SP - 273-274 TI - Left-sided breast cancer and risks of secondary lung cancer and ischemic heart disease-Effects of modern radiotherapy techniques (vol 194, pg 196, 2017). JO - Strahlenther. Onkol. VL - 194 IS - 3 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Devecka, M.* AU - Habl, G.* AU - Duma, M.N.* AU - Kampfer, S.* AU - Wilkens, J.J. AU - Kessel, K.A. AU - Combs, S.E. C1 - 52621 C2 - 44370 CY - Heidelberg SP - S155-S156 TI - Acute hematological toxicities in patients treated with (cranio)-spinal irradiation according to treatment technique and prior chemotherapy use. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Diehl, C.D.* AU - Peeken, J.C.* AU - Specht, H.M.* AU - Habermehl, D. AU - Combs, S.E. C1 - 52610 C2 - 44342 CY - Heidelberg SP - S180-S180 TI - Serum levels and outcome correlation of S100 and neuron pecific enolase (NSE) during radiation therapy of brain metastases. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Diehl, C.D.* AU - Schwendner, M.J.* AU - Sollmann, N.* AU - Meyer, B.* AU - Krieg, S.M.* AU - Combs, S.E. C1 - 52645 C2 - 44458 CY - Heidelberg SP - S40-S40 TI - Presurgical navigated transcranial motorcortex mapping data in radiotherapy planning: Motorcortex sparing in the treatment of brain tumors. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AB - Background and purpose: High-precision radiotherapy (RT) requires precise positioning, particularly with high single doses. Fiducial markers in combination with onboard imaging are excellent tools to support this. The purpose of this study is to establish a pancreatic cancer mouse model for high-precision image-guided RT (IGRT) using the liquid fiducial marker BioXmark (Nanovi, Kongens Lyngby, Denmark). Methods: In an animal-based cancer model, different volumes of BioXmark (10–50 µl), application forms, and imaging modalities—cone-beam computer tomography (CBCT) incorporated in either the Small Animal Radiation Research Platform (SARRP) or the small-animal micro-CT Scanner (SkyScan; Bruker, Brussels, Belgium)—as well as subsequent RT with the SARRP system were analyzed to derive recommendations for BioXmark. Results: Even small volumes (10 µl) of BioXmark could be detected by CBCT (SARRP and Skyscan). Larger volumes (50 µl) led to hardening artefacts. The position of BioXmark was monitored at least weekly by CBCT and was stable over 4 months. BioXmark was shown to be well tolerated; no changes in physical condition or toxic side effects were observed in comparison to control mice. BioXmark enabled an exact fusion with the original treatment plan with less hardening artefacts, and minimized the application o f contrast agent for fractionated RT. Conclusion: An orthotopic pancreatic tumor mouse model was established for high-precision IGRT using a fiducial marker. BioXmark was successfully tested and provides the perfect basis for improved imaging in high-precision RT. BioXmark enables a unique application method and optimal targeted precision in fractionated RT. Therefore, preclinical trials evaluating novel fractionation regimens and/or combination treatment with high-end RT can be performed. AU - Dobiasch, S.* AU - Kampfer, S.* AU - Burkhardt, R. AU - Schilling, D. AU - Schmid, T.E. AU - Wilkens, J.J. AU - Combs, S.E. C1 - 51845 C2 - 43531 CY - Heidelberg SP - 1039-1047 TI - BioXmark for high-precision radiotherapy in an orthotopic pancreatic tumor mouse model: Experiences with a liquid fiducial marker. JO - Strahlenther. Onkol. VL - 193 IS - 12 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Dobiasch, S.* AU - Kampfer, S.* AU - Burkhardt, R. AU - Wilkens, J.J. AU - Combs, S.E. C1 - 52644 C2 - 44439 CY - Heidelberg SP - S37-S38 TI - Use of the liquid fiducial marker BioXmark for high-precision radiotherapy of a tumor mouse model. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Dombrowsky, A. AU - Burger, K.* AU - Stein, M. AU - Dierolf, M.* AU - Guenther, B.* AU - Porth, A.* AU - Bartzsch, S.* AU - Urban, T.* AU - Achterhold, K.* AU - Gleich, B.* AU - Beyreuther, E.* AU - Pfeiffer, F.* AU - Combs, S.E. AU - Wilkens, J.J. AU - Schmid, T.E. C1 - 52639 C2 - 44410 CY - Heidelberg SP - S54-S54 TI - Setup for tumor growth delay studies in small animals for low energy x-rays and small irradiation fields. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Fischer, H.* AU - Kessel, K.A. AU - Duma, M.N.* AU - Habermehl, D.* AU - Scheidhauer, K.* AU - Combs, S.E. C1 - 52619 C2 - 44428 CY - Heidelberg SP - S167-S167 TI - The complaint profile of meningioma-patients after Usage of [68Ga] DOTANOC-PET in radiation treatment planning. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Gerhardt, S.* AU - Duma, M.N. AU - Wilkens, J.J. AU - Combs, S.E. AU - Oechsner, M.* C1 - 52623 C2 - 44427 CY - Heidelberg SP - S148-S148 TI - Evaluation of patient positioning with exactrac system for the irradiation of intracranial tumors. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AB - Background: Definition of gross tumor volume (GTV) in hepatocellular carcinoma (HCC) requires dedicated imaging in multiple contrast medium phases. The aim of this study was to evaluate the interobserver agreement (IOA) in gross tumor delineation of HCC in a multicenter panel. Methods: The analysis was performed within the “Stereotactic Radiotherapy” working group of the German Society for Radiation Oncology (DEGRO). The GTVs of three anonymized HCC cases were delineated by 16 physicians from nine centers using multiphasic CT scans. In the first case the tumor was well defined. The second patient had multifocal HCC (one conglomerate and one peripheral tumor) and was previously treated with transarterial chemoembolization (TACE). The peripheral lesion was adjacent to the previous TACE site. The last patient had an extensive HCC with a portal vein thrombosis (PVT) and an inhomogeneous liver parenchyma due to cirrhosis. The IOA was evaluated according to Landis and Koch. Results: The IOA for the first case was excellent (kappa: 0.85); for the second case moderate (kappa: 0.48) for the peripheral tumor and substantial (kappa: 0.73) for the conglomerate. In the case of the peripheral tumor the inconsistency is most likely explained by the necrotic tumor cavity after TACE caudal to the viable tumor. In the last case the IOA was fair, with a kappa of 0.34, with significant heterogeneity concerning the borders of the tumor and the PVT. Conclusion: The IOA was very good among the cases were the tumor was well defined. In complex cases, where the tumor did not show the typical characteristics, or in cases with Lipiodol (Guerbet, Paris, France) deposits, IOA agreement was compromised. AU - Gkika, E.* AU - Tanadini-Lang, S.* AU - Kirste, S.* AU - Holzner, P.A.* AU - Neeff, H.P.* AU - Rischke, H.C.* AU - Reese, T.* AU - Lohaus, F.* AU - Duma, M.N. AU - Dieckmann, K.* AU - Semrau, R.* AU - Stockinger, M.* AU - Imhoff, D.* AU - Kremers, N.* AU - Häfner, M.F.* AU - Andratschke, N.* AU - Nestle, U.* AU - Grosu, A.-L.* AU - Guckenberger, M.* AU - Brunner, T.B.* C1 - 51563 C2 - 43304 CY - Heidelberg SP - 823–830 TI - Interobserver variability in target volume delineation of hepatocellular carcinoma: An analysis of the working group “Stereotactic Radiotherapy” of the German Society for Radiation Oncology (DEGRO). JO - Strahlenther. Onkol. VL - 193 IS - 10 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Hofmeister, A.* AU - Duma, M.N. AU - Wiegandt, M.* AU - Combs, S.E. AU - Wilkens, J.J. AU - Oechsner, M.* C1 - 52625 C2 - 44423 CY - Heidelberg SP - S145-S145 TI - Reduction of the lung dose in stereotactic irradiation of lung tumors due to respiratory gating. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Kessel, C.* AU - Atkinson, M.J. AU - Trott, K.* AU - Berberat, P.* AU - Combs, S.E. C1 - 52618 C2 - 44371 CY - Heidelberg SP - S170-S170 TI - Quality assurance in higher education - traditional and innovative student feedback methods in the MSc Radiation Biology Program at the School of Medicine of the Technical University of Munich (TUM). JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AB - Background: Stereotactic radiotherapy (RT) has been established as a valid treatment alternative in patients with vestibular schwannoma (VS). There is ongoing controversy regarding the optimal fractionation. Hearing preservation may be the primary goal for patients with VS, followed by maintenance of quality of life (QoL). Methods: From 2002 to 2015, 184 patients with VS were treated with radiosurgery (RS) or fractionated stereotactic radiotherapy (FSRT). A survey on current symptoms and QoL was conducted between February and June 2016. Results: Median follow-up after RT was 7.5 years (range 0–14.4 years). Mean overall survival (OS) after RT was 31.1 years, with 94 and 87% survival at 5 and 10 years, respectively. Mean progression-free survival (PFS) was 13.3 years, with 5‑ and 10-year PFS of 92%. Hearing could be preserved in RS patients for a median of 36.3 months (range 2.3–13.7 years). Hearing worsened in 17 (30%) cases. Median hearing preservation for FSRT was 48.7 months (range 0.0–13.8 years); 29 (23%) showed hearing deterioration. The difference in hearing preservation was not significant between RS and FSRT (p = 0.3). A total of 123/162 patients participated in the patient survey (return rate 76%). The results correlate well with the information documented in the patient files for tinnitus and facial and trigeminal nerve toxicity. Significant differences appeared regarding hearing impairment, gait uncertainty, and imbalance. Conclusion: These data confirm that RS and FSRT are comparable in terms of local control for VS. RS should be reserved for smaller lesions, while FSRT can be offered independently of tumor size. Patient self-reported outcome during follow-up is of high value. The established questionnaire could be validated in the independent cohort. AU - Kessel, K.A. AU - Fischer, H. AU - Vogel, M.M. AU - Oechsner, M.* AU - Bier, H.* AU - Meyer, B.* AU - Combs, S.E. C1 - 49932 C2 - 41916 SP - 192-199 TI - Fractionated vs. single-fraction stereotactic radiotherapy in patients with vestibular schwannoma: Hearing preservation and patients’ self-reported outcome based on an established questionnaire. JO - Strahlenther. Onkol. VL - 193 IS - 3 PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Kessel, K.A. AU - Fischer, H. AU - Vogel, M.M. AU - Oechsner, M.* AU - Bier, H.* AU - Meyer, B.* AU - Combs, S.E. C1 - 50185 C2 - 42225 CY - Munich TI - Erratum to: Fractionated vs. single-fraction stereotactic radiotherapy in patients with vestibular schwannoma: Hearing preservation and patients’ self-reported outcome based on an established questionnaire. JO - Strahlenther. Onkol. VL - 193 IS - 2 PB - Urban & Vogel PY - 2017 SN - 0179-7158 ER - TY - JOUR AB - Objective: To evaluate long-term outcome after high-precision radiotherapy (RT) of meningioma patients in terms of survival and side effects. Methods: We analyzed 275 meningioma cases: 147 low-grade and 43 high-grade meningiomas (WHO II: n = 40, III: n = 3). In all, 85 patients had no pathologically confirmed histology but were determined as low-grade based on multimodal imaging. Surgery was performed in 183 cases. RT was delivered as either radiosurgery (RS, n = 16), fractionated stereotactic radiotherapy (FSRT, n = 241), or intensity-modulated radiation therapy (IMRT, n = 18). Of 218 patients contacted for patient-reported-outcome (PRO), 207 responded (95%). Results: Median follow-up was 7.2 years. For low-grade meningioma the survival rate (OS) was 97% at 3 years, 85% at 10 years, and 64% at 15 years, for atypical meningioma 91% at 3 years, 62% at 10 years, and 50% at 15 years. Local control rate (PFS) for low-grade meningioma was 91% at 3 years, 87% at 5 years, and 86% at 10 years, for atypical cases 67% at 3 years and 55% at 5 years. Of all, 3.0% of patients reported worsened or new symptoms grade ≥3 during RT and the first 6 months thereafter; 17.5% reported a deterioration after more than 2 years. We found the prognostic factors tumor volume and age significantly influencing OS and PFS. Conclusion: Complemented by PRO, we found long-term low toxicity rates in addition to excellent local control. Thus, due to the beneficial risk–benefit profile of benign and high-risk meningiomas, RT should be performed as adjuvant treatment and should not be postponed until tumor progression. AU - Kessel, K.A. AU - Fischer, H. AU - Oechnser, M.* AU - Zimmer, C.* AU - Meyer, B.* AU - Combs, S.E. C1 - 51400 C2 - 43047 CY - Heidelberg SP - 921-930 TI - High-precision radiotherapy for meningiomas: Long-term results and patient-reported outcome (PRO). JO - Strahlenther. Onkol. VL - 193 IS - 11 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Kessel, K.A. AU - Vogel, M.M. AU - Schmidt-Graf, F.* AU - Combs, S.E. C1 - 52613 C2 - 44360 CY - Heidelberg SP - S168-S168 TI - An only survey seeking healthcare professionals' opinion on mobile apps in oncology. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Kessel, K.A. AU - Hesse, J.* AU - Straube, C.* AU - Zimmer, C.* AU - Schmidt-Graf, F.* AU - Meyer, B.* AU - Combs, S.E. C1 - 52636 C2 - 44413 CY - Heidelberg SP - S95-S96 TI - Further development of an established prognostic score after re-irradiation of recurrent glioma. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Kessel, K.A. AU - Kessel, C.* AU - Vogel, M.M. AU - Bier, H.* AU - Biedermann, T.* AU - Friess, H.* AU - Herrschbach, P.* AU - von Eisenhart-Rothe, R.* AU - Meyer, B.* AU - Kiechle, M.* AU - Keller, U.* AU - Peschel, C.* AU - Schmid, R.* AU - Schwaiger, M.* AU - Combs, S.E. C1 - 52648 C2 - 44455 CY - Heidelberg SP - S23-S24 TI - Mobile applications in oncology - a survey on evaluating the patient acceptance in a German Oncology Center: Final analysis. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Kirstein, A.* AU - Specht, H.M.* AU - Kessel, K.A. AU - Zimmer, C.* AU - Meyer, B.* AU - Combs, S.E. C1 - 52620 C2 - 44372 CY - Heidelberg SP - S156-S157 TI - Change in resection cavity volume after surgery and local stereotactic radiotherapy of brain metastases. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Koelemenoglu, L.* AU - Schilling, D. AU - Reitz, S.* AU - Combs, S.E. C1 - 52646 C2 - 44457 CY - Heidelberg SP - S39-S39 TI - Selenium and zinc blood levels during radiation therapy the prospective, non-interventional SELINK-study. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AB - Background: Complementary and alternative medicine (CAM) are gaining in importance, but objective data are mostly missing. However, in previous trials, methods such as acupuncture showed significant advantages compared to standard therapies. Thus, the aim was to evaluate most frequently used methods, their significance and the general acceptance amongst cancer patients undergoing radiotherapy (RT). Methods: A questionnaire of 18 questions based on the categorical classification released by the National Centre for Complementary and Integrative Health was developed. From April to September 2015, all patients undergoing RT at the Department of Radiation Oncology, Technical University of Munich, completed the survey. Changes in attitude towards CAM were evaluated using the questionnaire after RT during the first follow-up visit (n = 31). Results: Of 634 patients, 333 answered the questionnaire (52.5%). Of all participants, 26.4% used CAM parallel to RT. Before RT, a total of 39.3% had already used complementary medicine. The most frequently applied methods during therapy were vitamins/minerals, food supplements, physiotherapy/manual medicine, and homeopathy. The majority (71.5%) did not use any complementary treatment, mostly stating that CAM was not offered to them (73.5%). The most common reasons for use were to improve the immune system (48%), to reduce side effects (43.8%), and to not miss an opportunity (37.8%). Treatment integrated into the individual therapy concept, e.g. regular acupuncture, would be used by 63.7% of RT patients. Conclusion: In comparison to other studies, usage of CAM parallel to RT in our department is considered to be low. Acceptance amongst patients is present, as treatment integrated into the individual oncology therapy would be used by about two-third of patients. AU - Lettner, S.* AU - Kessel, K.A. AU - Combs, S.E. C1 - 50455 C2 - 42446 CY - Munich SP - 419-425 TI - Complementary and alternative medicine in radiation oncology: Survey of patients’ attitudes. JO - Strahlenther. Onkol. VL - 193 IS - 5 PB - Urban & Vogel PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Maihoefer, C.* AU - Kienlechner, N.* AU - Schttrumpf, L.* AU - Baumeister, P.* AU - Macht, C.* AU - Pflugradt, U.* AU - Hess J. AU - Zitzelsberger, H. AU - Friedl, A.A.* AU - Belka, C.* AU - Ganswindt, U.* C1 - 52624 C2 - 44426 CY - Heidelberg SP - S147-S148 TI - The influence of anemia, nicotine abuse and co-morbidities in patients with adjuvant radio(chemo)therapy in HNSCC. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Martin, F.* AU - Wank, M. AU - Laemmer, F.* AU - Schlegel, J.* AU - Schilling, D.* AU - Schmid, T.E. AU - Combs, S.E. C1 - 52614 C2 - 44359 CY - Heidelberg SP - S166-S166 TI - ALDH1A1 expression enhances migration and radioresistance of glioblastoma cells. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Muench, S.* AU - Habermehl, D. AU - Agha, A.* AU - Belka, C.* AU - Combs, S.E. AU - Eckel, R.H.* AU - Friess, H.* AU - Gerbes, A.L.* AU - Nuessler, N.C.* AU - Schepp, W.* AU - Schmid, R.M.* AU - Schmitt, W.* AU - Schubert-Fritschle, G.* AU - Weber, B.* AU - Werner, J.* AU - Engel, J.* C1 - 52647 C2 - 44456 CY - Heidelberg SP - S33-S34 TI - Comparison of perioperative chemotherapy and neoadjuvant chemoradiation in patients with adenocarcinoma of the gastro-esophageal junction: A population-based evaluation of the Munich Cancer Registry. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Niyazi, M.* AU - Ruf, V.* AU - Fleischmann, D.* AU - Piehlmaier, D. AU - Mittelbronn, M.* AU - Giese, A.* AU - Zitzelsberger, H. AU - Belka, C. AU - Unger, K. C1 - 52641 C2 - 44408 CY - Heidelberg SP - S52-S52 TI - Independent validation of a prognostic 4-miRNA signature in de novo glioblastoma. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AB - Purpose: To assess the impact of different reference CT datasets on manual image registration with free-breathing three-dimensional (3D) cone beam CTs (FB-CBCT) for patient positioning by several observers. Methods: For 48 patients with lung lesions, manual image registration with FB-CBCTs was performed by four observers. A slow planning CT (PCT), average intensity projection (AIP), maximum intensity projection (MIP), and midventilation CT (MidV) were used as reference images. Couch shift differences between the four reference CT datasets for each observer as well as shift differences between the observers for the same reference CT dataset were determined. Statistical analyses were performed and correlations between the registration differences and the 3D tumor motion and the CBCT score were calculated. Results: The mean 3D shift difference between different reference CT datasets was the smallest for AIPvsMIP (range 1.1–2.2 mm) and the largest for MidVvsPCT (2.8–3.5 mm) with differences > 10 mm. The 3D shifts showed partially significant correlations to 3D tumor motion and CBCT score. The interobserver comparison for the same reference CTs resulted in the smallest ∆3D mean differences and mean ∆3D standard deviation for ∆AIP (1.5 ± 0.7 mm, 0.7 ± 0.4 mm). The maximal 3D shift difference between observers was 10.4 mm (∆MidV). Both 3D tumor motion and mean CBCT score correlated with the shift differences (R s = 0.336–0.740). Conclusion: The applied reference CT dataset impacts image registration and causes interobserver variabilities. The 3D tumor motion and CBCT quality affect shift differences. The smallest differences wer e found for AIP which might be the most appropriate CT dataset for image registration with FB-CBCT. AU - Oechsner, M.* AU - Chizzali, B.* AU - Devecka, M.* AU - Münch, S.* AU - Combs, S.E. AU - Wilkens, J.J. AU - Duma, M.N. C1 - 51619 C2 - 43328 CY - Heidelberg SP - 831–839 TI - Interobserver variability of patient positioning using four different CT datasets for image registration in lung stereotactic body radiotherapy. JO - Strahlenther. Onkol. VL - 193 IS - 10 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Oechsner, M.* AU - Chizzali, B.* AU - Devecka, M.* AU - Muench, S.* AU - Wilkens, J.J. AU - Combs, S.E. AU - Duma, M.N. C1 - 52631 C2 - 44417 CY - Heidelberg SP - S120-S120 TI - Inter-observer-comparison concerning the effects of the reference-CT on image registration with 3D cone beam CTs in lung stereotaxy. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Ott, J. AU - Mutschelknaus, L. AU - Mörtl, S. AU - Schmid, T.E. AU - Atkinson, M.J. AU - Anastasov, N. AU - Combs, S.E. C1 - 52628 C2 - 44420 CY - Heidelberg SP - S141-S142 TI - Characterization of migration of four mammary carcinoma cell lines after irradiation. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AB - Introduction: Radiomics, a recently introduced concept, describes quantitative computerized algorithm-based feature extraction from imaging data including computer tomography (CT), magnetic resonance imaging (MRT), or positron-emission tomography (PET) images. For radiation oncology it offers the potential to significantly influence clinical decision-making and thus therapy planning and follow-up workflow. Methods: After image acquisition, image preprocessing, and defining regions of interest by structure segmentation, algorithms are applied to calculate shape, intensity, texture, and multiscale filter features. By combining multiple features and correlating them with clinical outcome, prognostic models can be created. Results: Retrospective studies have proposed radiomics classifiers predicting, e. g., overall survival, radiation treatment response, distant metastases, or radiation-related toxicity. Besides, radiomics features can be correlated with genomic information (“radiogenomics”) and could be used for tumor characterization. Discussion: Distinct patterns based on data-based as well as genomics-based features will influence radiation oncology in the future. Individualized treatments in terms of dose level adaption and target volume definition, as well as other outcome-related parameters will depend on radiomics and radiogenomics. By integration of various datasets, the prognostic power can be increased making radiomics a valuable part of future precision medicine approaches. Conclusion: This perspective demonstrates the evidence for the radiomics concept in radiation oncology. The necessity of further studies to integrate radiomics classifiers into clinical decision-making and the radiation therapy workflow is emphasized. AU - Peeken, J.C.* AU - Nüsslin, F.* AU - Combs, S.E. C1 - 51559 C2 - 43258 CY - Heidelberg SP - 767–779 TI - “Radio-oncomics”: The potential of radiomics in radiation oncology. JO - Strahlenther. Onkol. VL - 193 IS - 10 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Peeken, J.C.* AU - Diehl, C.* AU - Combs, S.E. AU - Duma, M.N.* C1 - 52629 C2 - 44419 CY - Heidelberg SP - S129-S129 TI - Evaluation of IMRT-based simultaneous integrated protection (SIP) concepts in re-irradiations of bone metastases. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Peeken, J.C.* AU - Hesse, J.* AU - Kessel, K.* AU - Nuesslin, F.* AU - Combs, S.E. C1 - 52643 C2 - 44459 CY - Heidelberg SP - S51-S51 TI - Creation of a joint prognostic model by combining clinical and qualitative imaging features for Glioblastoma Multiforme patients. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Piehlmaier, D. AU - Stegen, B.* AU - Nieto, A.* AU - Orth, M.* AU - Niyazi, M.* AU - Ruf, V.* AU - Hess J. AU - Zitzelsberger, H. AU - Lauber, K. AU - Unger, K. C1 - 52626 C2 - 44422 CY - Heidelberg SP - S154-S154 TI - In-vitro and in-vivo characterization of a glioblastoma cell line panel. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Radtke, A.* AU - Wank, M. AU - Schilling, D. AU - Reindl, J.* AU - Schmid, T.E. AU - Combs, S.E. C1 - 52627 C2 - 44421 CY - Heidelberg SP - S152-S153 TI - Hypoxia-induced radio-resistance in glioblastoma cells as a function of the LET. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Ruehle, P.F.* AU - Goerig, N.* AU - Korn, K.* AU - Überla, K.* AU - Wunderlich, R. AU - Fietkau, R.* AU - Gaipl, U.S.* AU - Frey, B.* C1 - 52642 C2 - 44441 CY - Heidelberg SP - S50-S50 TI - GLIO-CMV-01: Identification of immune biomarkers for CMV related encephalitis during standard brain radiotherapy. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AB - Background: Radiotherapy (RT) is an established treatment for patients with primary and recurrent prostate cancer. Herein, the effects of definitive and salvage RT on the composition of lymphocyte subpopulations were investigated in patients with prostate cancer to study potential immune effects. Patients and methods: A total of 33 prostate cancer patients were treated with definitive (n = 10) or salvage RT (n = 23) after biochemical relapse. The absolute number of lymphocytes and the distribution of lymphocyte subpopulations were analyzed by multiparameter flow cytometry before RT, at the end of RT, and in the follow-up period. Results: Absolute lymphocyte counts decreased significantly after RT in both patient groups and a significant drop was observed in the percentage of B cells directly after RT from 10.1 ± 1.3 to 6.0 ± 0.7% in patients with definitive RT and from 9.2 ± 0.8 to 5.8 ± 0.7% in patients with salvage RT. In contrast, the percentages of T and natural killer (NK) cells remained unaltered directly after RT in both patient groups. However, 1 year after RT, the percentage of CD3+ T cells was significantly lower in patients with definitive and salvage RT. The percentage of regulatory T cells was slightly upregulated in primary prostate cancer patients after definitive RT, but not after salvage RT. Conclusion: Definitive and salvage RT exert similar effects on the composition of lymphocyte subpopulations in prostate cancer patients. Total lymphocyte counts are lower in both patient groups compared to healthy controls and further decreased after RT. B cells are more sensitive to definitive and salvage RT than T and NK cells. AU - Sage, E.K.* AU - Schmid, T.E. AU - Geinitz, H.* AU - Gehrmann, M.* AU - Sedelmayr, M.* AU - Duma, M.N. AU - Combs, S.E. AU - Multhoff, G. C1 - 51184 C2 - 42839 CY - Heidelberg SP - 648–655 TI - Effects of definitive and salvage radiotherapy on the distribution of lymphocyte subpopulations in prostate cancer patients. JO - Strahlenther. Onkol. VL - 193 IS - 8 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Sage, E.K.* AU - Schmied, T.E. AU - Geinitz, H.* AU - Gehrmann, M.* AU - Sedelmayr, M.* AU - Duma, M.N. AU - Combs, S.E. AU - Multhoff, G. C1 - 52609 C2 - 44200 CY - Heidelberg SP - S180-S181 TI - Effects of local radiotherapy on the composition of lymphocyte subpopulations in prostate and breast cancer patients. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Scharl, S.* AU - Straube, C.* AU - Meyer, B.* AU - Schmidt-Graf, F.* AU - Combs, S.E. C1 - 52285 C2 - 43831 CY - Heidelberg SP - 984-988 TI - Critical consideration of the European Association for Neuro-Oncology (EANO) guideline on the diagnosis and treatment of adult astrocytic and oligodendroglial gliomas. JO - Strahlenther. Onkol. VL - 193 IS - 11 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Schmid, T.E. AU - Greubel, C.* AU - Ilicic, K.* AU - Walsh, D.W.M.* AU - Reindl, J.* AU - Siebenwirth, C.* AU - Sammer, M.* AU - Wilkens, J.J.* AU - Multhoff, G.* AU - Dollinger, G.* AU - Schmid, E.* AU - Combs, S.E. C1 - 52634 C2 - 44415 CY - Heidelberg SP - S104-S105 TI - Submicrometer focusing of low LET protons - understanding the RBE of heavy ion irradiation. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Schneider, L. AU - Selmansberger, M. AU - Schuettrumpf, L. AU - Maihoefer, C. AU - Pflugradt, U. AU - Kirchner, T.* AU - Woischke, C.* AU - Belka, C. AU - Zitzelsberger, H. AU - Ganswindt, U. AU - Unger, K. AU - Hess J. C1 - 52622 C2 - 44369 CY - Heidelberg SP - S149-S149 TI - Subgroups of HPV-positive and HPV-negative head and neck squamous cell carcinoma differing in global copy number changes and prognosis. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Schoetz, U.* AU - Orth, M.* AU - Selmansberger, M. AU - Schuster, J.* AU - Stegen, B.* AU - Ganswindt, U. AU - Maihoefer, C. AU - Schuettrumpf, L. AU - Hess J. AU - Unger, K. AU - Zitzelsberger, H. AU - Belka, C. AU - Lauber, K. C1 - 52637 C2 - 44412 CY - Heidelberg SP - S85-S85 TI - Increased CD44v6 expression confers radioresistance in subsets of HNSCC. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Straube, C.* AU - Combs, S.E. C1 - 51305 C2 - 42951 CY - Munich SP - 510-512 TI - Kombination von Strahlentherapie mit Temozolomid bei über 65-jährigen Glioblastompatienten. JO - Strahlenther. Onkol. VL - 193 IS - 6 PB - Urban & Vogel PY - 2017 SN - 0179-7158 ER - TY - JOUR AB - Background: Currently, patients with gross total resection (GTR) of recurrent glioblastoma (rGBM) undergo adjuvant chemotherapy or are followed up until progression. Re-irradiation, as one of the most effective treatments in macroscopic rGBM, is withheld in this situation, as uncertainties about the pattern of re-recurrence, the target volume, and also the efficacy of early re-irradiation after GTR exist. Methods: Imaging and clinical data from 26 consecutive patients with GTR of rGBM were analyzed. The spatial pattern of recurrences was analyzed according to the RANO-HGG criteria (“response assessment in neuro-oncology criteria for high-grade gliomas”). Progression-free (PFS) and overall survival (OS) were analyzed by the Kaplan–Meier method. Furthermore, a systematic review was performed in PubMed. Results: All but 4 patients underwent adjuvant chemotherapy after GTR. Progression was diagnosed in 20 of 26 patients and 70% of recurrent tumors occurred adjacent to the resection cavity. The median extension beyond the edge of the resection cavity was 20 mm. Median PFS was 6 months; OS was 12.8 months. We propose a target volume containing the resection cavity and every contrast enhancing lesion as the gross tumor volume (GTV), a spherical margin of 5–10 mm to generate the clinical target volume (CTV), and a margin of 1–3 mm to generate the planning target volume (PTV). Re-irradiation of this volume is deemed to be safe and likely to prolong PFS. Conclusion: Re-irradiation is worth considering also after GTR, as the volumes that need to be treated are limited and re-irradiation has already proven to be a safe treatment option in general. The strategy of early re-irradiation is currently being tested within the GlioCave/NOA 17/Aro 2016/03 trial. AU - Straube, C.* AU - Elpula, G.* AU - Gempt, J.* AU - Gerhardt, J.* AU - Bette, S.* AU - Zimmer, C.* AU - Schmidt-Graf, F.* AU - Meyer, B.* AU - Combs, S.E. C1 - 51409 C2 - 43229 CY - Heidelberg SP - 897–909 TI - Re-irradiation after gross total resection of recurrent glioblastoma: Spatial pattern of recurrence and a review of the literature as a basis for target volume definition. JO - Strahlenther. Onkol. VL - 193 IS - 11 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Straube, C.* AU - Elpulka, G. AU - Gempt, J.* AU - Gerhardt, J.* AU - Bette, S.* AU - Zimmer, C.* AU - Schmidt-Graf, F.* AU - Meyer, B.* AU - Combs, S.E. C1 - 52635 C2 - 44414 CY - Heidelberg SP - S100-S101 TI - Moving Re-Irradition forward: Generation of target volume guidelines in patients with recurrent glioblastoma following gross total resection. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AB - Objective The TNM 8 lung cancer staging system reclassifies patients with a solitary extrathoracic metastasis as M1b and two or more extrathoracic metastases as M1c. This study investigates the clinical relevance of this change. Methods Advanced lung cancer patients were retrospectively restaged according to the TNM8 M1b and M1c classifiers. Overall survival was compared in M1b and M1c patients staged with and without PET-CT. We then summarized the TNM 8 staging classification and the relevant literature on the treatment of oligometastatic lung cancer. Results In all, 82 patients with metastatic lung cancer were reclassified according to the TNM 8: 14 had M1b and 58 had M1c disease. Those with M1b disease lived significantly longer than those with M1c disease (15.2 vs. 7.3 months, p = 0.0029). Among those with M1b disease, survival was the highest when M1b status was confirmed by PET-CT (21.4 vs. 7 months). M1c patients with 4 or less distant metastases had a trend to longer survival vs. M1c patients with 5 or more metastases (9.4 vs. 7.3 months), especially when PET-CT staging was used (13.9 months). Conclusions We confirmed the prognostic value of the M1b and M1c descriptors in a Western European tertiary care population. The use of PET-CT seems to increase the prognostic value of the M descriptor and may define an additional oligometastatic subgroup of M1c patients. Clinical trials investigating the treatment of patients with varying degrees of metastatic disease are needed and should be based on PET-CT staging. AU - Tufman, A. AU - Kahnert, K. AU - Kauffmann-Guerrero, D. AU - Manapov, F. AU - Milger, K. AU - Müller-Lisse, U. AU - Winter, H. AU - Huber, R.M. AU - Schneider, C. C1 - 51130 C2 - 43127 CY - Munich SP - 392-401 TI - Clinical relevance of the M1b and M1c descriptors from the proposed TNM 8 classification of lung cancer. JO - Strahlenther. Onkol. VL - 193 IS - 5 PB - Urban & Vogel PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Vogel, M.M. AU - Kessel, K.A. AU - Combs, S.E. C1 - 52612 C2 - 44345 CY - Heidelberg SP - S171-S171 TI - Mobile applications in oncology: App-assisted treatment and research. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Wunderlich, R. AU - Unger, K. AU - Hess J. AU - Lauber, K. AU - Frey, B.* AU - Gaipl, U.* AU - Zitzelsberger, H. C1 - 52638 C2 - 44411 CY - Heidelberg SP - S84-S84 TI - Irradiated HPV+ head and neck cancer cells induce an interferon related gene expression in various innate immune cell subtypes. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AU - Zahnbrecher, E.* AU - Sammer, M.* AU - Reindl, J.* AU - Greubel, C.* AU - Schwarz, B.* AU - Siebenwirth, C.* AU - Walsh, D.W.M.* AU - Ilicic, K.* AU - Wilkens, J.J. AU - Dollinger, G.* AU - Combs, S.E. AU - Schmid, T.E. C1 - 52617 C2 - 44357 CY - Heidelberg SP - S171-S171 TI - Reduced acute side effects by proton mini beam radiation therapy in the mouse ear model. JO - Strahlenther. Onkol. VL - 193 PB - Springer Heidelberg PY - 2017 SN - 0179-7158 ER - TY - JOUR AB - Purpose: The prognosis for high-grade glioma (HGG) patients is poor; thus, treatment-related side effects need to be minimized to conserve quality of life and functionality. Advanced techniques such as proton radiation therapy (PRT) and volumetric-modulated arc therapy (VMAT) may potentially further reduce the frequency and severity of radiogenic impairment. Materials and methods: We retrospectively assessed 12 HGG patients who had undergone postoperative intensity-modulated proton therapy (IMPT). VMAT and 3D conformal radiotherapy (3D-CRT) plans were generated and optimized for comparison after contouring crucial neuronal structures important for neurogenesis and neurocognitive function. Integral dose (ID), homogeneity index (HI), and inhomogeneity coefficient (IC) were calculated from dose statistics. Toxicity data were evaluated. Results: Target volume coverage was comparable for all three modalities. Compared to 3D-CRT and VMAT, PRT showed statistically significant reductions (p < 0.05) in mean dose to whole brain (−20.2 %, −22.7 %); supratentorial (−14.2 %, −20,8 %) and infratentorial (−91.0 %, −77.0 %) regions; brainstem (−67.6 %, −28.1 %); pituitary gland (−52.9 %, −52.5 %); contralateral hippocampus (−98.9 %, −98.7 %); and contralateral subventricular zone (−62.7 %, −66.7 %, respectively). Fatigue (91.7 %), radiation dermatitis (75.0 %), focal alopecia (100.0 %), nausea (41.7 %), cephalgia (58.3 %), and transient cerebral edema (16.7 %) were the most common acute toxicities. Conclusion: Essential dose reduction while maintaining equal target volume coverage was observed using PRT, particularly in contralaterally located critical neuronal structures, areas of neurogenesis, and structures of neurocognitive functions. These findings were supported by preliminary clinical results confirming the safety and feasibility of PRT in HGG. AU - Adeberg, S.* AU - Harrabi, S.B.* AU - Bougatf, N.* AU - Bernhardt, D.* AU - Rieber, J.* AU - Koerber, S.A.* AU - Syed, M.* AU - Sprave, T.* AU - Mohr, A.* AU - Abdollahi, A.* AU - Haberer, T.* AU - Combs, S.E. AU - Herfarth, K.* AU - Debus, J.* AU - Rieken, S.* C1 - 48971 C2 - 41518 CY - Munich SP - 770-779 TI - Intensity-modulated proton therapy, volumetric-modulated arc therapy, and 3D conformal radiotherapy in anaplastic astrocytoma and glioblastoma : A dosimetric comparison. JO - Strahlenther. Onkol. VL - 192 IS - 11 PB - Urban & Vogel PY - 2016 SN - 0179-7158 ER - TY - JOUR AB - Image-guided radiotherapy (IGRT) has been integrated into daily clinical routine and can today be considered the standard especially with high-dose radiotherapy. Currently imaging is based on MV- or kV-CT, which has clear limitations especially in soft-tissue contrast. Thus, combination of magnetic resonance (MR) imaging and high-end radiotherapy opens a new horizon. The intricate technical properties of MR imagers pose a challenge to technology when combined with radiation technology. Several solutions that are almost ready for routine clinical application have been developed. The clinical questions include dose-escalation strategies, monitoring of changes during treatment as well as imaging without additional radiation exposure during treatment. AU - Combs, S.E. AU - Nüsslin, F.* AU - Wilkens, J.J. C1 - 47932 C2 - 39730 CY - Munich SP - 209-215 TI - Individualized radiotherapy by combining high-end irradiation and magnetic resonance imaging. JO - Strahlenther. Onkol. VL - 192 IS - 4 PB - Urban & Vogel PY - 2016 SN - 0179-7158 ER - TY - JOUR AU - Combs, S.E. C1 - 49122 C2 - 41658 CY - Munich SP - 498-499 TI - Protonentherapie bei Kindern mit Medulloblastom bei akzeptablen Nebenwirkungen ähnlich erfolgreich wie Photonentherapie. JO - Strahlenther. Onkol. VL - 192 IS - 7 PB - Urban & Vogel PY - 2016 SN - 0179-7158 ER - TY - JOUR AB - Gliome vom WHO-Grad II treten in der Regel bei jungen Erwachsenen auf und sind zumeist mit progredienten neurologischen Defiziten sowie einer eingeschränkten Lebenserwartung assoziiert. Im Rahmen der vorliegenden RTOG-Studie wurde der Stellenwert einer Kombination von Bestrahlung und Chemotherapie mit PCV (Procarbacin, CCNU, Vincristin) untersucht. Initiale Ergebnisse hatten bereits einen Vorteil der Kombination hinsichtlich des progressionsfreien Überlebens gezeigt, nicht aber bisher für das Gesamtüberleben. In der vorliegenden Arbeit werden die Langzeitergebnisse berichtet. AU - Combs, S.E. AU - Schmidt-Graf, F.* AU - Meyer, B.* C1 - 49654 C2 - 40869 CY - Munich SP - 672-674 TI - Bessere Prognose von Low-grade-Gliomen durch Kombination von Bestrahlung, Procarbazin, CCNU und Vincristin. JO - Strahlenther. Onkol. VL - 192 IS - 9 PB - Urban & Vogel PY - 2016 SN - 0179-7158 ER - TY - JOUR AB - Background and purpose: Low-grade glioma (LGG) is a very common brain tumor in pediatric patients typically associated with a very good prognosis. This prognosis makes it imperative that the risk of long-term treatment-related side effects be kept at an absolute minimum. Proton therapy (PRT) provides a radiation technique that has the potential to further reduce the genesis of radiogenic impairment. Materials and methods: We retrospectively assessed 74 patients with LGG who underwent PRT. Conventional three-dimensional photon and PRT plans were generated after contouring structures of neurogenesis, crucial neuronal structures, and areas susceptible to secondary malignancies. Target volume coverage was evaluated using the homogeneity index (HI) and inhomogeneity coefficient (IC). Results were compared using the Wilcoxon-signed rank test, with p < 0.05 being statistically significant. Results: Target volume coverage was comparable for the photon and proton plans. Overall, we could show an essential reduction in maximal, mean, and integral doses in critical neurologic structures, areas of neurogenesis, and structures of neurocognitive function. The study indicated specifically how contralaterally located structures could be spared with PRT. Conclusion: PRT is a highly conformal radiation technique offering superior dosimetric advantages over conventional radiotherapy by allowing significant dose reduction for organs at risk (OAR) that are essential for neurologic function, neurocognition, and quality of life, thus demonstrating the potential of this technique for minimizing long-term sequelae. AU - Harrabi, S.B.* AU - Bougatf, N.* AU - Mohr, A.* AU - Haberer, T.* AU - Herfarth, K.* AU - Combs, S.E. AU - Debus, J.* AU - Adeberg, S.* C1 - 49033 C2 - 41565 CY - Munich SP - 759-769 TI - Dosimetric advantages of proton therapy over conventional radiotherapy with photons in young patients and adults with low-grade glioma. JO - Strahlenther. Onkol. VL - 192 IS - 11 PB - Urban & Vogel PY - 2016 SN - 0179-7158 ER - TY - JOUR AB - Purpose: Volumetric-modulated arc therapy (VMAT) achieves high conformity to the planned target volume (PTV) and good sparing of organs at risk (OAR). This study compares dosimetric parameters and toxicity in esophageal cancer (EC) patients treated with VMAT and 3D conformal radiotherapy (3D-CRT). Materials and methods: Between 2007 and 2014, 17 SC patients received neoadjuvant chemoradiation (CRT) with VMAT. Dose–volume histograms and toxicity were compared between these patients and 20 treated with 3D-CRT. All patients were irradiated with a total dose of 45 Gy. All VMAT patients received simultaneous chemotherapy with cisplatin and 5‑fluorouracil (5-FU) in treatment weeks 1 and 5. Of 20 patients treated with 3D-CRT, 13 (65 %) also received CRT with cisplatin and 5‑FU, whereas 6 patients (30 %) received CRT with weekly oxaliplatin and cetuximab, and a continuous infusion of 5‑FU (OE-7). Results: There were no differences in baseline characteristics between the treatment groups. For the lungs, VMAT was associated with a higher V5 (median 90.1 % vs. 79.7 %; p = 0.013) and V10 (68.2 % vs. 56.6 %; p = 0.014), but with a lower V30 (median 6.6 % vs. 11.0 %; p = 0.030). Regarding heart parameters, VMAT was associated with a higher V5 (median 100.0 % vs. 91.0 %; p = 0.043), V10 (92.0 % vs. 79.2 %; p = 0.047), and Dmax (47.5 Gy vs. 46.3 Gy; p = 0.003), but with a lower median dose (18.7 Gy vs. 30.0 Gy; p = 0.026) and V30 (17.7 % vs. 50.4 %; p = 0.015). Complete resection was achieved in 16 VMAT and 19 3D-CRT patients. Due to systemic progression, 2 patients did not undergo surgery. The most frequent postoperative complication was anastomosis insufficiency, occurring in 1 VMAT (6.7 %) and 5 3D-CRT patients (27.8 %; p = 0.180). Postoperative pneumonia was seen in 2 patients of each group (p = 1.000). There was no significant difference in 3‑year overall (65 % VMAT vs. 45 % 3D-CRT; p = 0.493) or 3‑year progression-free survival (53 % VMAT vs. 35 % 3D-CRT; p = 0.453). Conclusion: Although dosimetric differences in lung and heart exposure were observed, no clinically relevant impact was detected in either patient group. In a real-life patient cohort, VMAT enables reduction of lung and heart V30 compared to 3D-CRT, which may contribute to reduced toxicity. AU - Münch, S.* AU - Aichmeier, S.* AU - Hapfelmeier, A.* AU - Duma, M.N.* AU - Oechsner, M.* AU - Feith, M.* AU - Combs, S.E. AU - Habermehl, D.* C1 - 49180 C2 - 41709 CY - Munich SP - 722-729 TI - Comparison of dosimetric parameters and toxicity in esophageal cancer patients undergoing 3D conformal radiotherapy or VMAT. JO - Strahlenther. Onkol. VL - 192 IS - 10 PB - Urban & Vogel PY - 2016 SN - 0179-7158 ER - TY - JOUR AB - Purpose: Aim of this single center, retrospective study was to assess the efficacy and safety of linear accelerator-based hypofractionated stereotactic radiotherapy (HFSRT) to the resection cavity of brain metastases after surgical resection. Local control (LC), locoregional control (LRC = new brain metastases outside of the treatment volume), overall survival (OS) as well as acute and late toxicity were evaluated. Patients and methods: 46 patients with large (> 3 cm) or symptomatic brain metastases were treated with HFSRT. Median resection cavity volume was 14.16 cm3 (range 1.44–38.68 cm3) and median planning target volume (PTV) was 26.19 cm3 (range 3.45–63.97 cm3). Patients were treated with 35 Gy in 7 fractions prescribed to the 95–100 % isodose line in a stereotactic treatment setup. LC and LRC were assessed by follow-up magnetic resonance imaging. Results: The 1-year LC rate was 88 % and LRC was 48 %; 57% of all patients showed cranial progression after HFSRT (4% local, 44% locoregional, 9% local and locoregional). The median follow-up was 19 months; median OS for the whole cohort was 25 months. Tumor histology and recursive partitioning analysis score were significant predictors for OS. HFSRT was tolerated well without any severe acute side effects > grade 2 according to CTCAE criteria. Conclusion: HFSRT after surgical resection of brain metastases was tolerated well without any severe acute side effects and led to excellent LC and a favorable OS. Since more than half of the patients showed cranial progression after local irradiation of the resection cavity, close patient follow-up is warranted. A prospective evaluation in clinical trials is currently being performed. AU - Specht, H.M.* AU - Kessel, K.A. AU - Oechsner, M.* AU - Meyer, B.* AU - Zimmer, C.* AU - Combs, S.E. C1 - 48156 C2 - 39988 CY - Munich SP - 368-376 TI - HFSRT of the resection cavity in patients with brain metastases. JO - Strahlenther. Onkol. VL - 192 IS - 6 PB - Urban & Vogel PY - 2016 SN - 0179-7158 ER - TY - JOUR AB - BACKGROUND: By studying the bioenergetic status we could show that the development of tumor hypoxia is accompanied, apart from myriad other biologically relevant effects, by a substantial accumulation of adenosine (ADO). ADO has been shown to act as a strong immunosuppressive agent in tumors by modulating the innate and adaptive immune system. In contrast to ADO, standard radiotherapy (RT) can either stimulate or abrogate antitumor immune responses. Herein, we present ADO-mediated mechanisms that may thwart antitumor immune responses elicited by RT. MATERIALS AND METHODS: An overview of the generation, accumulation, and ADO-related multifaceted inhibition of immune functions, contrasted with the antitumor immune effects of RT, is provided. RESULTS: Upon hypoxic stress, cancer cells release ATP into the extracellular space where nucleotides are converted into ADO by hypoxia-sensitive, membrane-bound ectoenzymes (CD39/CD73). ADO actions are mediated upon binding to surface receptors, mainly A2A receptors on tumor and immune cells. Receptor activation leads to a broad spectrum of strong immunosuppressive properties facilitating tumor escape from immune control. Mechanisms include (1) impaired activity of CD4 (+) T and CD8 (+) T, NK cells and dendritic cells (DC), decreased production of immuno-stimulatory lymphokines, and (2) activation of Treg cells, expansion of MDSCs, promotion of M2 macrophages, and increased activity of major immunosuppressive cytokines. In addition, ADO can directly stimulate tumor proliferation and angiogenesis. CONCLUSION: ADO mechanisms described can thwart antitumor immune responses elicited by RT. Therapeutic strategies alleviating tumor-promoting activities of ADO include respiratory hyperoxia or mild hyperthermia, inhibition of CD39/CD73 ectoenzymes or blockade of A2A receptors, and inhibition of ATP-release channels or ADO transporters. AU - Vaupel, P.* AU - Multhoff, G. C1 - 48135 C2 - 39911 CY - Munich SP - 279-287 TI - Adenosine can thwart antitumor immune responses elicited by radiotherapy : Therapeutic strategies alleviating protumor ADO activities. JO - Strahlenther. Onkol. VL - 192 IS - 5 PB - Urban & Vogel PY - 2016 SN - 0179-7158 ER - TY - JOUR AU - Combs, S.E. AU - Farzin, M.* AU - Boehmer, J.* AU - Oehlke, O.* AU - Molls, M.* AU - Debus, J.* AU - Grosu, A.-L.* C1 - 47332 C2 - 40562 SP - S38 TI - Clinical outcome after high-precision radiotherapy for skull base meningiomas: Pooled data from three large German Centers of Radiation Oncology. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Dittmar, J.O.* AU - Klein, K.* AU - Ketter, R.* AU - Urbschat, S.* AU - Hoffmann, S.* AU - Dittmar, A.* AU - Habermehl, D.* AU - Oertel, J.* AU - Debus, J.* AU - Combs, S.E. C1 - 47323 C2 - 39332 SP - S146 TI - Changes of the meningioma specific chromosomal aberration after radiotherapy with photons or carbon ions. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Dittmar, J.O.* AU - Stade, F.* AU - Mielke, T.* AU - Habermehl, D.* AU - Kratochwill, C.* AU - Dittmar, A.* AU - Welzel, T.* AU - Haberkorn, U.* AU - Debus, J.* AU - Combs, S.E. C1 - 47324 C2 - 40549 SP - S151-S152 TI - The [Ga-68]-DOTA-D Phe 1-3Tyr3-Octreotide (DOTATOC)- based radiotherapy planning leads to improved organ preservation risk at the proton- radiotherapy of intracranial meningiomas. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Dittmar, J.O.* AU - Picht, D.* AU - Oechsner, M.* AU - Berndt, J.* AU - Duma, M.* AU - Habermehl, D.* AU - Wilkens, J.J.* AU - Combs, S.E. C1 - 47331 C2 - 40561 SP - S154 TI - An automated treatment planning leads to a significant time savings during radiosurgical treatment multiple brain metastases - an evaluation of the tools, brain metastases for brainlab. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Gunther, S.* AU - Specht, H.M.* AU - Erl, J.* AU - Breuninger, S.* AU - Combs, S.E. AU - Multhoff, G. C1 - 47322 C2 - 40550 SP - S72-S73 TI - Development of a novel LipHsp70 ELISA for screening of exosomal Hsp70 in the blood of NSCLC patients. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Hess J. AU - Gimenez-Aznar, I. AU - Michna, A. AU - Kuger, S. AU - Klein, D.* AU - Schoetz, U.* AU - Orth, M.* AU - Hieber, L. AU - Braselmann, H. AU - Schuettrumpf, L. AU - Jendrossek, V.* AU - Belka, C. AU - Zangen, V. AU - Unger, K. AU - Zitzelsberger, H. AU - Lauber, K. C1 - 47326 C2 - 40552 SP - S77 TI - Signalling networks associated with FancA mediated radioresistance in cells of head and neck squamous cell carcinoma. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Kuger, S. AU - Hess J. AU - Schötz, U. AU - Gimenez-Aznar, I. AU - Michna, A. AU - Orth, M.* AU - Hieber, L. AU - Braselmann, H. AU - Klein, D.* AU - Schuettrumpf, L. AU - Jendrossek, V.* AU - Belka, C. AU - Zangen, V. AU - Unger, K. AU - Zitzelsberger, H. AU - Lauber, K. C1 - 47330 C2 - 40560 SP - S90 TI - The influence of FancA overexpression on radioresistance in oral keratinocytes and HNSCC cells. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Lettner, S.* AU - Kessel, K.A.* AU - Combs, S.E. C1 - 47321 C2 - 40548 SP - S13 TI - Complementary medical teatment as part of the radio oncology therapy - questionnaire for the evaluation of acceptance and of dealing with the range of therapies in a large German department for radiation oncology. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Maihoefer, C.* AU - Schuettrumpf, L.* AU - Macht, C.* AU - Pflugradt, U.* AU - Rauch, J.* AU - Baumeister, P.* AU - Zitzelsberger, H. AU - Friedl, A.A.* AU - Belka, C.* AU - Ganswindt, U.* C1 - 47328 C2 - 40558 SP - S119-S120 TI - Implementation of a clinical database for the evaluation of the treatment results of patients with HNSCC - outcome of 195 monocentrically adjuvant treated patients from 2008 to 2012. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Orth, M.* AU - Unger, K. AU - Belka, C.* AU - Lauber, K.* C1 - 47327 C2 - 40553 SP - S81 TI - Paclitaxel-mediated radiosensitization is based on aneuploidization and depends on high expression levels of Aurora A kinase and TPX2. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Penterling, C.* AU - Wilke, C. AU - Unger, K. AU - Friedl, A.A. C1 - 47325 C2 - 40551 SP - S76 TI - Analysis of radiation-induced transcriptome alterations in a p53-compromised cell line. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Schneider, L. AU - Belka, C. AU - Budach, W.* AU - Zitzelsberger, H. AU - Unger, K. AU - Hess J. C1 - 47337 C2 - 40567 SP - S86-S87 TI - Identification and validation of predictive markers in head and neck squamous cell carcinomas. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Schoetz, U.* AU - Shnayien, S.* AU - Kinzel, L.* AU - Hess J. AU - Zitzelsberger, H. AU - Klein, D.* AU - Jendrossek, V.* AU - Belka, C.* AU - Unkel, S.* AU - Lauber, K.* C1 - 47333 C2 - 40563 SP - S121 TI - Inherent radioresistance of head and neck squamous cell carcinoma cells: Principal component analysis identifies cellular senescence as a crucial driver. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Specht, H.M.* AU - Kessel, K.A.* AU - Meyer, B.* AU - Ringel, F.* AU - Schiller, K.* AU - Combs, S.E. C1 - 47320 C2 - 40547 SP - S37 TI - Local hypofractionated stereotactic radiotherapy (HFSRT) after surgical resection of brain metastasis. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Specht, H.M.* AU - Neff, T.* AU - Kessel, K.A.* AU - Lukas, P.* AU - Molls, M.* AU - Petry, W.* AU - Reuschel, W.* AU - Wagner, F.M.* AU - Wilkens, J.J.* AU - Combs, S.E. C1 - 47336 C2 - 40566 SP - S66 TI - Evaluation of treatment concepts and indications for Fast Neutron Therapy (FNT) using reactor fission neutrons. JO - Strahlenther. Onkol. VL - 191 PY - 2015 SN - 0179-7158 ER - TY - JOUR AU - Hess J. AU - Gimenez-Aznar, I. AU - Michna, A. AU - Hieber, L. AU - Braselmann, H. AU - Schuettrumpf, L. AU - Unger, K. AU - Zangen, V. AU - Klein, D.* AU - Jendrossek, V.* AU - Belka, C. AU - Zitzelsberger, H. AU - Lauber, K. C1 - 31753 C2 - 34758 CY - Munich SP - 29 TI - FANCA overexpression confers radioresistance to cells of head and neck squamous cell carcinoma. JO - Strahlenther. Onkol. VL - 190 PB - Urban & Vogel PY - 2014 SN - 0179-7158 ER - TY - JOUR AU - Maroschik, B.* AU - Guertler, A. AU - Krämer, A. AU - Roessler, U.* AU - Gomolka, M.* AU - Hornhardt, S.* AU - Mörtl, S. AU - Friedl, A.A.* C1 - 31752 C2 - 34759 CY - Munich SP - 81 TI - Radiation-induced alterations of histone post-translational modification levels in lymphoblastoid cell lines. JO - Strahlenther. Onkol. VL - 190 PB - Urban & Vogel PY - 2014 SN - 0179-7158 ER - TY - JOUR AU - Michna, A. AU - Braselmann, H. AU - Guertler, A.* AU - Gomolka, M.* AU - Hornhardt, S.* AU - Bluethgen, N.* AU - Sieber, A.* AU - Zitzelsberger, H. AU - Unger, K. C1 - 31751 C2 - 34760 CY - Munich SP - 77 TI - Identification of molecular targets and signalling networks that influence sensitivity to ionising radiation. JO - Strahlenther. Onkol. VL - 190 PB - Urban & Vogel PY - 2014 SN - 0179-7158 ER - TY - JOUR AU - Multhoff, G. AU - Trott, K.-R.* C1 - 10965 C2 - 30432 SP - 91-92 TI - Screening von Genpolymorphismen verbessert die Vorhersage der Strahlentoxizität nicht. JO - Strahlenther. Onkol. VL - 189 IS - 1 PB - Urban & Vogel PY - 2013 SN - 0179-7158 ER - TY - JOUR AB - Ziel einer effektiven Tumortherapie ist es, sowohl das Wachstum des Primärtumors zu kontrollieren, als auch langanhaltende und spezifische Antitumor-Immunantworten gegen den Primärtumor, Rezidive und Metastasen zu induzieren. An der Eliminierung von Tumor- sowie bakteriell und viral infizierten Zellen sind im Wesentlichen die antigenspezifischen CD8+ zytotoxischen und CD4+ T-Helferzellen, die beide dem adaptiven Immunsystem angehören, und die natürlichen Killerzellen (NK), die als Mitglieder der angeborenen Immunabwehr Zielzellen ohne vorherige antigenspezifische Stimulation lysieren, beteiligt. AU - Multhoff, G. AU - Gaipl, U.S.* AU - Niedermann, G.* C1 - 8611 C2 - 30209 SP - 312-315 TI - Die Rolle der Strahlentherapie bei der Induktion von Antitumor-Immunantworten. JO - Strahlenther. Onkol. VL - 188 IS - Suppl. 3 PB - Urban & Vogel PY - 2012 SN - 0179-7158 ER - TY - JOUR AB - BACKGROUND AND PURPOSE: High levels of hypoxia inducible factor (HIF)-1α in tumors are reported to be associated with tumor progression and resistance to therapy. To examine the impact of HIF-1α on radioresistance under normoxia, the sensitivity towards irradiation was measured in human tumor cell lines that differ significantly in their basal HIF-1α levels. MATERIAL AND METHODS:HIF-1α levels were quantified in lysates of H1339, EPLC-272H, A549, SAS, XF354, FaDu, BHY, and CX- tumor cell lines by ELISA. Protein levels of HIF-1α, HIF-2α, carbonic anhydrase IX (CA IX), and GAPDH were assessed by Western blot analysis. Knock-down experiments were performed using HIF-1α siRNA. Clonogenic survival after irradiation was determined by the colony forming assay. RESULTS: According to their basal HIF-1α status, the tumor cell lines were divided into low (SAS, XF354, FaDu, A549, CX-), intermediate (EPLC-272H, BHY), and high (H1339) HIF-1α expressors. The functionality of the high basal HIF-1α expression in H1339 cells was proven by reduced CA IX expression after knocking-down HIF-1α. Linear regression analysis revealed no correlation between basal HIF-1α levels and the survival fraction at either 2 or 4 Gy in all tumor cell lines investigated. CONCLUSION: Our data suggest that basal HIF-1α levels in human tumor cell lines do not predict their radiosensitivity under normoxia. AU - Schilling, D. AU - Bayer, C.* AU - Emmerich, K.* AU - Molls, M.* AU - Vaupel, P.* AU - Huber, R.M.* AU - Multhoff, G. C1 - 7159 C2 - 29499 SP - 353-358 TI - Basal HIF-1α expression levels are not predictive for radiosensitivity of human cancer cell lines. JO - Strahlenther. Onkol. VL - 188 IS - 4 PB - Springer PY - 2012 SN - 0179-7158 ER - TY - JOUR AB - Hintergrund und Ziel: Ab Ende der 40er Jahre bis 2005 war die Behandlung des Morbus Bechterew mit intravenös appliziertem Radium-224 (224Ra) ein im deutschsprachigen Raum übliches Therapieverfahren. In dieser Langzeituntersuchung wurde das Risiko maligner Erkrankungen nach intravenöser Behandlung des Morbus Bechterew mit 224Ra ermittelt. Patienten und Methodik: Im Rahmen einer prospektiven Langzeit-Nachbeobachtungsstudie wurden 1 471 Patienten untersucht, die zwischen 1948 und 1975 zur Therapie eines Morbus Bechterew intravenöse Injektionen von 224Ra erhalten hatten. Als Vergleich diente eine Kontrollgruppe von 1 324 Bechterew-Patienten, die weder mit 224Ra noch mit Röntgenstrahlen behandelt worden waren. Mit Hilfe standardisierter Fragebögen wurde der Gesundheitszustand der Patienten abgefragt. Die Anzahl registrierter maligner Fälle wurde mit jener der Kontrollgruppe sowie mit Erwartungswerten einer Normalpopulation verglichen. Ergebnisse: Nach einem Nachbeobachtungszeitraum von 26 Jahren liegen in der Expositionsgruppe bei 1 006 Patienten gesicherte Todesursachen vor (Kontrollgruppe: 1 072 Patienten). Unter den mit 224Ra behandelten Patienten zeigten sich im Unterschied zur Kontrollgruppe signifikant erhöhte Inzidenzraten für myeloische Leukämien (zwölf beobachtete Fälle vs. 2,9 erwartete Fälle; p < 0,001), Nierenkarzinome (18 vs. 9,1 Fälle; p < 0,01), Schilddrüsenkarzinome (vier vs. 1,2 Fälle; p = 0,03) sowie grenzwertig signifikant erhöhte Inzidenzraten für maligne Tumorerkrankungen des weiblichen Genitaltrakts (zehn vs. 5,6 Fälle; p = 0,06). Die Häufigkeiten maligner Tumoren der Lunge und des Magen-Darm-Trakts waren nicht erhöht. Lymphatische Leukämien (Expositionsgruppe: acht vs. 2,7 Fälle; p < 0,01; Kontrollgruppe: sieben vs. drei Fälle; p = 0,03) traten sowohl in der Expositions- als auch in der Kontrollgruppe gehäuft auf, wobei in beiden Gruppen insbesondere die Rate an chronisch-lymphatischer Leukämie erhöht war. Schlussfolgerung: Die Therapie des Morbus Bechterew mittels 224Ra hat zu erhöhten Häufigkeiten myeloischer Leukämien sowie maligner Tumoren der Nieren, Schilddrüse und des weiblichen Genitaltrakts geführt. Obwohl diese Therapie mittlerweile nicht mehr durchgeführt wird, sollten behandelte Patienten weiterhin nachuntersucht werden. AU - Schulte, T.L.* AU - Nekolla, E.A.* AU - Wick, R.R. C1 - 1603 C2 - 27124 CY - München SP - 549-556 TI - Langzeituntersuchung zum Risiko maligner Erkrankungen nach intravenöser Behandlung des Morbus Bechterew mit Radium-224. JO - Strahlenther. Onkol. VL - 185 IS - 9 PB - Urban & Vogel PY - 2009 SN - 0179-7158 ER - TY - JOUR AB - Encouraging results of phase II studies combining chemotherapy with radiotherapy have been published. In this study, the results of a multimodal salvage therapy including radiochemotherapy (RCT) and regional hyperthermia (RHT) in preirradiated patients with recurrent rectal cancer are reported. PATIENTS AND METHODS: All patients enrolled had received previous pelvic irradiation (median dose 50.4 Gy). The median time interval between prior radiotherapy and the onset of local recurrence was 34 months. The combined treatment consisted of reirradiation with a median dose of 39.6 Gy (30.0-45.0 Gy), delivered in fractions of 1.8 Gy/day. 5-fluorouracil was given as continuous infusion 350 mg/m(2)/day five times weekly, and RHT (BSD-2000 system) was applied twice a week within 1 h after radiotherapy. The primary endpoint was local progression-free survival (LPFS); secondary endpoints were overall survival, symptom control, and toxicity. RESULTS: 24 patients (median age 59 years) with a previously irradiated locally recurrent adenocarcinoma of the rectum were enrolled. The median LPFS was 15 months (95% confidence interval 12-18 months] with a median follow-up of 27 months (16-37 months). The overall 1-year and 3-year survival rates were 87% and 30%, respectively. Pain was the main symptom in 17 patients. Release of pain was achieved in 12/17 patients (70%). No grade 3 or 4 hematologic or skin toxicity occurred. Grade 3 gastrointestinal acute toxicity was observed in 12.5% of the patients. Paratumoral thermometry revealed a homogeneous distribution of temperatures. CONCLUSION: RCT combined with RHT is an efficient salvage therapy showing high efficacy with acceptable toxicity and can be recommended as treatment option for this unfavorable group of preirradiated patients with local recurrence of rectal cancer. AU - Milani, V.* AU - Pazos, M.* AU - Issels, R.D. AU - Buecklein, V.* AU - Rahman, S.* AU - Tschoep, K.* AU - Schaffer, P.* AU - Wilkowski, R.* AU - Duehmke, E.* AU - Schäffer, M.* C1 - 2935 C2 - 25217 SP - 163-168 TI - Radiochemotherapy in combination with regional hyperthermia in preirradiated patients with recurrent rectal cancer. JO - Strahlenther. Onkol. VL - 184 IS - 3 PB - Urban & Vogel PY - 2008 SN - 0179-7158 ER - TY - JOUR AB - Preparations of rat detrusor vesicae urinariae exposed to 50 kV X-irradiation with 10 to 200 Gy (single dose) at dose-rates of 30 and 60 Gy/min reacted immediately with a dose and dose-rate dependent reversible or persistent increase (up to ten hours) of the basal tone and an increase or a decrease of the acetylcholine contractile response. The motor activity was recorded isotonically. For measurements of time changes following treatment in vivo the bladder was locally irradiated from lateral position with single 300 kV X-ray doses of 10, 25 and 50 Gy. The motor reaction of isolated detrusor preparations to acetylcholine had a threshold concentration in control animals of 2.3 X 10(-10) mol/l (n = 33); the sensitivity to acetylcholine was diminished as early as one to two hours after local irradiation with 50 Gy as reflected in a ten times higher threshold concentration, which decreased further with time past treatment up to 40 days. The inhibitory effect after 25 Gy was weaker. The contractile response of acetylcholine at different concentrations (10(-10) to 10(-5) mol/l) was also diminished after irradiation (50 Gy). It is suggested that the pathophysiological reactions of the radiogenic bladder are based on multifactorial mechanisms and X-ray induced tonic contraction as well as inhibition of the acetylcholine contractile response could be essential factors for the clinically observed hypertonia of the irradiated bladder ("radiogene Harnblase") and its functional volume decrease as well as of the diminished pressure during micturition. AU - Michailov, M.C. AU - Neu, E. AU - Tempel, K. AU - Hölzl, H. AU - Breiter, N. C1 - 18980 C2 - 11761 SP - 311-318 TI - Influence of X-irradiation on the Motor Activity of the Rat Urinary Bladder in Vitro and in Vivo. JO - Strahlenther. Onkol. VL - 167 IS - 5 PY - 1991 SN - 0179-7158 ER - TY - JOUR AB - Preparations of rat detrusor vesicae urinariae exposed to 50 kV X-irradiation with 10 to 200 Gy (single dose) at dose-rates of 30 and 60 Gy/min reacted immediately with a dose and dose-rate dependent reversible or persistent increase (up to ten hours) of the basal tone and an increase or a decrease of the acetylcholine contractile response. The motor activity was recorded isotonically. For measurements of time changes following treatment in vivo the bladder was locally irradiated from lateral position with single 300 kV X-ray doses of 10, 25 and 50 Gy. The motor reaction of isolated detrusor preparations to acetylcholine had a threshold concentration in control animals of 2.3 x 10-10 mol/l (n = 33); the sensitivity to acetylcholine was diminished as early as one to two hours after local irradiation with 50 Gy as reflected in a ten times higher threshold concentration, which decreased further with time past treatment up to 40 days. The inhibitory effect after 25 Gy was weaker. The contractile response of acetylcholine at different concentrations (10-10 to 10-5 mol/l) was also diminished after irradiation (50 Gy). It is suggested that the pathophysiological reactions of the radiogenic bladder are based on multifactorial mechanisms and X-ray induced tonic contraction as well as inhibition of the acetylcholine contractile response could be essential factors for the clinically observed hypertonia of the irradiated bladder ('radiogene Harnblase') and its functional volume decrease as well as of the diminished pressure during micturition. AU - Michailov, M.C. AU - Neu, E. AU - Tempel, K.H. AU - Hölzl, H. AU - Breiter, N. C1 - 33811 C2 - 35457 SP - 311-318 TI - Influence of X-irradiation on the motor activity of rat urinary bladder in vitro and in vivo. JO - Strahlenther. Onkol. VL - 167 IS - 5 PY - 1991 SN - 0179-7158 ER - TY - JOUR AU - Sassy, T. AU - Breiter, N. AU - Trott, K.-R. C1 - 18336 C2 - 11527 TI - Die Wirkung von Tetrachlordecaoxid (TCDO) auf den chronischen Strahlenschaden am Rattenkolon. JO - Strahlenther. Onkol. PY - 1990 SN - 0179-7158 ER - TY - JOUR AU - Burger, G. C1 - 18635 C2 - 11207 SP - 291-293 TI - Cytometry, a Possible Tool for Assessment of Tumor Response. JO - Strahlenther. Onkol. VL - 165 PY - 1989 SN - 0179-7158 ER - TY - JOUR AU - Burger, G. AU - Wambersie, A. AU - Breit, A. AU - Bewley, D. AU - Scherer, E. C1 - 18636 C2 - 11208 SP - 259-356 TI - Advances in radiobiology and neutron radiotherapy. JO - Strahlenther. Onkol. VL - 165 PY - 1989 SN - 0179-7158 ER - TY - JOUR AU - Burger, G.T. C1 - 42235 C2 - 34804 SP - 291-293 TI - Cytometry, a possible tool for assessment of tumor response. JO - Strahlenther. Onkol. VL - 165 IS - 4 PY - 1989 SN - 0179-7158 ER - TY - JOUR AB - At the Munich RENT-facility a screening project was performed to define the biological characteristics of a fission neutron beam envisaged for radiotherapy. The quantitative endpoints used were jejunal crypt survival, late rectal stenosis in rats, osseous healing in traumatized rat femur and regrowth delay of murine transplantable tumours. The results obtained in normal tissues (with the possible exception of bone) demonstrate a high RBE, in accordance with the well documented dependence of RBE on neutron energy. The RBE-values measured in tumours after single dose treatment endorsed the high effectiveness, although--as has been the case with other beams--they gave no conclusive evidence of a therapeutic advantage. Nevertheless, the specific beam characteristics, i.e. a high RBE at the surface and a fast decline of the biologically effective depth dose suggest possible advantages of the RENT beam when applied in the treatment of selected superficial tumours. AU - Kummermehr, J. AU - Schraube, H. AU - Ries, G. AU - Köster, L. AU - Höver, K.-H. AU - Blattmann, H. AU - Stas, P. AU - Burger, G. C1 - 17884 C2 - 11204 SP - 276-282 TI - Biological Effectiveness of Neutrons and pi-mesons in Gut, Bone, and Transplantable Tumours. JO - Strahlenther. Onkol. VL - 165 IS - 4 PY - 1989 SN - 0179-7158 ER - TY - JOUR AB - The reaction of isolated helical strips of rat aorta to X-irradiation was studied: X-rays (50 kV) induced a reproducible, reversible contractile response at threshold doses of 2.5 Gy (60 Gy/min) and 10 Gy (30 Gy/min). After repeated irradiation with the same doses at equal time intervals and constant dose-rate (for example 50 Gy every 15 min, dose-rate 60 Gy/min) the contractile response was progressively diminished, i.e. a tachyphylaxis appeared. The preparations still reacted even after total doses over 1000 Gy. The X-ray induced contractile responses were dose- and dose-rate dependent. Quantitative analysis indicated no essential differences in the radiation-induced contractile response when recorded under isometric or isotonic conditions. After hypothermia (20°C) or hyperthermia (42°C) no visible radiation response could be induced. Part of the aortic strips were spontaneously active: X-ray doses of 5 to 10 Gy stimulated, while doses of 100 to 200 Gy inhibited or blocked the spontaneous phasic activity. A comparison between the immediate X-ray reaction of vascular and non-vascular smooth muscle preparations is given. Participation of cholinergic and adrenergic mechanisms in the X-ray induced contractions of rat aorta seems to be ruled out, because the blocking agents atropine, phentolamine, and bretylium had no effect. AU - Michailov, M.C. AU - Amelung, H. AU - Welscher, U.E. AU - Neu, E. C1 - 42551 C2 - 10356 SP - 860-865 TI - Reaktionen der isolierten Rattenaorta auf Röntgenstrahlung. JO - Strahlenther. Onkol. VL - 165 IS - 12 PY - 1989 SN - 0179-7158 ER - TY - JOUR AU - Ries, G. AU - Kneschaurek, P. AU - Breit, A. AU - Koester, L. AU - Wagner, F.M. AU - Kummermehr, J. AU - Trott, K.-R. AU - Burger, G. AU - Schraube, H. C1 - 18637 C2 - 11209 SP - 302-305 TI - First Experiences with Fission Neutrons in the Radiation Therapy of Cancer Patients. JO - Strahlenther. Onkol. VL - 165 PY - 1989 SN - 0179-7158 ER - TY - JOUR AB - On the basis of endoscopic investigations, the reaction to X-radiation of the hindgut of the rat could be divided into four phases. Their courses after different radiation doses as well as after dietary influence are described. This enabled us - besides the acute (diarrhoea) and chronic (diarrhoea followed by intestinal occlusion) phases shown by clinical examination - to demonstrate the early vascular reaction (first week after irradiation) as well as the asymptomatic interval between the acute and chronic phases. The interval phase was found to be of special importance for prognosis and therapy, because all animals who died later on of intestinal occlusion developed already during this phase circular ulcerations which could be demonstrated by endoscopy. AU - Breiter, N. AU - Sassy, T. AU - Trott, K.R. AU - Unsöld, E. C1 - 33870 C2 - 36201 SP - 674-680 TI - Die endoskopische Verlaufskontrolle und deren histologische Korrelation des chronischen Strahlenschadens am Enddarm der Ratte. JO - Strahlenther. Onkol. VL - 164 IS - 11 PY - 1988 SN - 0179-7158 ER - TY - JOUR AB - The radiobiological basis of a hyperfractionated radiation therapy versus conventional fractionation with respect to therapeutic gain, i.e., improved normal tissue sparing for the same level of tumour cell inactivation, will be presented. Data on the recovery potential of various tissues as well as the kinetics of repair will be given. The problem of incomplete repair with short irradiation intervals will be discussed. AU - Hagen, U. AU - Guttenberger, R. AU - Kummermehr, J. C1 - 17785 C2 - 10696 SP - 653-656 TI - Intrazelluläre Erholung - Grundlagen der Hyperfraktionierung. JO - Strahlenther. Onkol. VL - 164 IS - 11 PY - 1988 SN - 0179-7158 ER - TY - JOUR AB - The radiobiological basis of a hyperfractionated radiation therapy versus conventional fractionation with respect to therapeutic gain, i.e., improved normal tissue sparing for the same level of tumour cell inactivation, will be presented. Data on the recovery potential of various tissues as well as the kinetics of repair will be given. The problem of incomplete repair with short irradiation intervals will be discussed. AU - Hagen, U. AU - Guttenberger, R. AU - Kummermehr, J.C. C1 - 33652 C2 - 35469 SP - 653-656 TI - Intracellular recovery--basis of hyperfractionation | Intrazelluläre Erholung--Grundlage der Hyperfraktionierung. JO - Strahlenther. Onkol. VL - 164 IS - 11 PY - 1988 SN - 0179-7158 ER - TY - JOUR AU - Michailov, M.C. AU - Amelung, H. AU - Welscher, U. AU - Neu, E. C1 - 17450 C2 - 10356 TI - Reactions of isolated rat aorta to X-irradiation. JO - Strahlenther. Onkol. PY - 1988 SN - 0179-7158 ER - TY - JOUR AU - Issels, R.D. AU - Nagele, A. AU - Boning, B. AU - Bourier, S. AU - Wilmanns, W. C1 - 41174 C2 - 40449 SP - 420-421 TI - Thiol-compounds as thermosensitizer: Experimental results. JO - Strahlenther. Onkol. VL - 163 IS - 7 PY - 1987 SN - 0179-7158 ER - TY - JOUR AU - Chmelevsky, D. AU - Kellerer, A.M. AU - Spieß, H.F. AU - Mays, C.W. C1 - 41016 C2 - 36111 SP - 32-37 TI - A proportional hazards analysis of bone sarcoma rates in German 244radium patients. JO - Strahlenther. Onkol. VL - 162 IS - 80 PY - 1986 SN - 0179-7158 ER - TY - JOUR AB - Intrauterine ultrasonography has proved to be an adequate method to represent the normal myometrium as well as its pathologic modifications, especially for the assessment of the localization and extent of malignant processes. So for the first time, intracavitary radiotherapy of the carcinoma of the body, especially the afterloading technique, can work by means of the produced cross-sections with a precisely defined target volume, because the sonographic probe and the afterloading probe have identical geometric configurations. A method is presented which allows a computer-assisted determination of the tumor volume by means of the segmentation of organ sections and a pseudo-threedimensional projection in combination with the energy dose distribution of the radioactive source. AU - Englmeier, K.-H. AU - Hecker, R. AU - Hötzinger, H. AU - Thiel, H.J. C1 - 41367 C2 - 40428 SP - 275-280 TI - Automatische kontursuche und Segmentierung von sonographischen transversalschnittbildern des Uterus hinsichtlich einer optimierten individuellen Isodosengestaltung bei Korpuskarzinomen. JO - Strahlenther. Onkol. VL - 161 IS - 5 PY - 1985 SN - 0179-7158 ER - TY - JOUR AB - Cyclic AMP, used as dibutyryl derivative for better permeability, has a relaxing effect on smooth muscle preparations from human uterine tissue (surgical material). The observed decrease of tonus and frequency depends on the concentration applied, shown in the range between 50 and 300 μM. cAMP looses its physiological activity by irradiation in vitro; in addition an inhibitory action of the irradiation products on uterine tissue could be proved. From the data of the Lineweaver-Burk plots, showing the competition between non-irradiated and irradiated cAMP, a ten- to twentyfold higher affinity of the irradiation products to the receptor compared to that of this transmitter could be calculated. The results show that preparations of human origin with β-receptors behave similarly to animal tissues with β-receptors. They are further discussed with respect to a better understanding of dose-response curves for chemical and physiological inactivation. AU - Schachinger, L. AU - Srivastava, A.K. AU - Schippel, C. AU - Klöter, H. C1 - 41062 C2 - 40384 SP - 358-365 TI - Effect of irradiated dib-cAMP on the tonic and phasic activity of human myometrium. JO - Strahlenther. Onkol. VL - 159 IS - 6 PY - 1983 SN - 0179-7158 ER - TY - JOUR AB - In this study, the authors describe how to determine the effective dose-equivalent absorbed by occupationally-exposed persons during a gynecologic radium therapy. The observed irradiation conditions of the physician and the medical staff are approximated by a standard geometry, for which conversion factors between the measured personal dose, the effective-dose equivalent and different organ doses, respectively, are calculated. The results are job-specific conversion factors between the dose dose according to a personal dosimeter and the effective dose-equivalent for the occupational-exposed persons involved. According to the individual tasks, these factors are between 0.59 and 1.13. AU - Eckerl, H. AU - Thomasz, E. AU - Drexler, G.G. C1 - 41419 C2 - 40429 SP - 422-426 TI - Ermittlung der effektiven äquivalentdosis bei der Gynakologischen Radiumtherapie. JO - Strahlenther. Onkol. VL - 158 IS - 7 PY - 1982 SN - 0179-7158 ER - TY - JOUR AB - The fibrosarcoma SSK 31 was irradiated under ambient or hypoxic conditions either acutely or at various intervals after a priming dose of 13 Gy. The absence of local recurrences was determined. The hypoxic fraction and the time course of reoxygenation were calculated on the basis of a comparison of the cure curves. AU - Kummermehr, J.C. AU - Fink, R. AU - Preuss-Bayer, G. AU - Trott, K.R. C1 - 41483 C2 - 40432 SP - 272-276 TI - Reoxygenierung in einem Transplantabelen fibrosakom der Maus. JO - Strahlenther. Onkol. VL - 157 IS - 4 PY - 1981 SN - 0179-7158 ER - TY - JOUR AB - In the frame of a pilot project for percutaneous tumor treatment using a reactor produced fission beam, a small therapy planning prestudy has been performed. The fundamental data for the depth dose distribution in a phantom are derived from transport calculations for neutrons and from published measurements for the gamma contribution. Simple decrementline approaches are used to represent the beam profiles. Tissue-air-ratios known from Co-60 irradiations, are adjusted by simple density corrections to fit the required depth dose characteristics. It is shown that for the calculation of the dose in a material which is different to tissue, with respect to composition, a unique kerma ratio in the depth region of interest can be applied. Some examples of tumor treatment in the head and neck are planned. They show that the fission neutron beam is applicable in the treatment of superficial and half deep tumors with respect to dose homogeneity, but there are clear limitations as far as tumor size and position are concerned. AU - Schraube, H. AU - Koester, L. AU - Breit, A. C1 - 41038 C2 - 40363 SP - 190-198 TI - Status report on neutron treatment planning for the rent-project. JO - Strahlenther. Onkol. VL - 157 IS - Spec. Iss. 77 PY - 1981 SN - 0179-7158 ER - TY - JOUR AB - After X-irradiation with 200 rd on day 12 of gestation in the mouse, many typical cell clusters (rosettes) presumably originating from the ependymal layer can be observed in the central nervous system on day 18 p.c. In addition, many necrotic areas are found close to the ventricular surface in the subependymal layer, which is the main place of reparative cell proliferation. Typically, glial cells are arranged radially around these necrotic areas, in so doing druse-like structures which can be regarded as a peculiarity of the reparative process. Only macrophages and no astrocytal cell reactions are to be found. Immediately after birth the rosettes, as well as the druse-like structures, begin to collapse. The rosettes appear to be more marked off from their surroundings and many of them are in a degenerative state. Those situated near the ventricular surface form vaults with distinct dequamative properties. The outcome of this atrophy is a flattening of the cortical wall and the appearance of smooth-walled cysts, predominantly at the lateral angles of the telencephalic walls. No reactive process, especially no glial scarring, can be observed. This cyst formation proceeds after birth in a centrifugal direction, until clear porencephaly evolvement becomes noticeable. It is concluded that these peculiar reparative morphological changes are connected with the drastic physiological alterations which occur at birth. Fetal X-irradiation may be followed by a metabolic disorder, which leads to the definite histological effect of porencephaly only after birth, when metabolic imbalances are most critical. AU - Schmahl, W.G. AU - Weber, L.W.D. AU - Kriegel, H. C1 - 33019 C2 - 35255 SP - 347-357 TI - X-irradiation of mice in the early fetal period. I. Assessment of lasting CNS deficits developing mainly in the subsequent perinatal period. JO - Strahlenther. Onkol. VL - 155 IS - 5 PY - 1979 SN - 0179-7158 ER - TY - JOUR AB - Chinese hamster cells were exposed to 60Co gamma-rays using dose rates between 3.64 and 0.01 Gy/min under euoxic or chronically hypoxic conditions of growth in order to clarify the relationship of the oxygen enhancement ratio (OER) to the dose rate. It turned out that the D(o) of dose-effect curves from cells irradiated under euoxic conditions was increasing from 1.35 to 4.5 Gy with decreasing dose rates, whereas the curves from cells irradiated under chronically hypoxic conditions were not much influenced by the dose rate. The oxygen enhancement ratio decreased from 3.9 with 1.35 Gy/min to 1.8 with 0.07 Gy/min. AU - Born, R. C1 - 42522 C2 - 40425 SP - 650-652 TI - Die Abhänigkeit des Sauerstoffeffekts von der Dosisleistung. JO - Strahlenther. Onkol. VL - 154 IS - 9 PY - 1978 SN - 0179-7158 ER - TY - JOUR AB - Transplantable adenocarcinomas of C3H-mice were irradiated with doses between 7 and 75 Gy, using a dose rate of 3.6 Gy/min, or with doses from 10 to 80 Gy using dose rates between 0.06 and 0.17 Gy/min a 60Co-gamma source. A radiation-induced delay of growth or the local cure were recorded. The relative effectiveness of irradiation of the tumor using a low dose rate decreases at first down to a value of 0.66 at 25 to 30 Gy, if the doses are increased; then, if the doses delivered are further increased, it mounts again to 0.88 when the median curative radiation dose is reached. AU - Trott, K.R. C1 - 41942 C2 - 35746 SP - 656-658 TI - Der Einfluss der Dosisleistung auf die therapeutische Wirkung von 60CO-Gammabestrahlung beim Adenokarzinom der Maus. JO - Strahlenther. Onkol. VL - 154 IS - 9 PY - 1978 SN - 0179-7158 ER - TY - JOUR AB - Transplantable adenocarcinomas of the C3H mouse were treated with fractionated radiotherapy combined with local hyperthermia of 43.5°C for 20 min before each dose fraction and local cure rate was determined. The sensitizing effect of hyperthermia was seen with fractionated treatment as well as with single treatment. The TER (thermal enhancement ratio), however, decreased with decreasing interval between the fractions. AU - von Szczepanski, L. AU - Trott, K.R. C1 - 41841 C2 - 35791 SP - 653-655 TI - Fraktionierte Radio-Hyperthermie-Behandlung transplantabler Adenokarzinome der Maus. JO - Strahlenther. Onkol. VL - 154 IS - 9 PY - 1978 SN - 0179-7158 ER - TY - JOUR AB - Das bei doppelseitiger 60Co-Bestrahlung eines homogenen Ganzkoerperphantoms und eines quadratischen Phantoms sich in Phantommitte und an der Oberflaeche der Strahleneintrittsseiten ergebende Gewebe-Luft-Verhaeltnis wird mit Messergebnissen am Patienten verglichen. An einem einfachen Wasserphantom wurden die Dosisanteile der Streustrahlung und deren effektive Energie bestimmt. Untersuchungen ueber den Einfluss der Beckenschaufeln auf die Midline-Dosis ergaben, dass ausser diesen auch andere Knochenstrukturen im Beckenbereich fuer die niedrige Rektaldosis am Patienten verantwortlich sein muessen. Rektaldosiswerte sollten daher nicht als repraesentativ fuer die Midline-Dosis angesehen werden. Die Abhaengigkeit der Dosisaenderung in Phantommitte vom Quellenabstand wird diskutiert. AU - Hochhaeuser, E. C1 - 40948 C2 - 40378 SP - 820-824 TI - Zum Gewebe- Luft- Verhältnis bei doppelseitiger Ganzkörperbestrahlung. JO - Strahlenther. Onkol. VL - 153 IS - 12 PY - 1977 SN - 0179-7158 ER - TY - JOUR AB - By means of a formula, developed by J. Schubert and A. Catsch, H.J. Heller, as well as a relation postulated by A. Catsch, the 'thermodynamic' stability constant of the Radium (222)-cryptate K(Ra)(Ra)(222) was calculated from measurements of the total body retention of the radioactive alkaline earthes 85SR, 140Ba and 224Ra and its (222)-cryptates in rats. From the same in vivo data, a direct lineary relationship between the log of the effectiveness quotient, log EQ(M(222)), and the log of the 'thermodynamic' stability log K(M)(M)(222) was found graphically. The values from the graph correspond with those of the calculation. AU - Müller, W.H. C1 - 42202 C2 - 35668 SP - 570-571 TI - Predictibility of the stability constant of a radium cryptate by means of in vivo data from radioactive alkaline earthes. JO - Strahlenther. Onkol. VL - 153 IS - 8 PY - 1977 SN - 0179-7158 ER - TY - JOUR AB - Eine Ganzkoerper-Roentgenbestrahlung gravider NMRI-Maeuse zwischen dem 11. und 13. Tag post concept. fuehrt ausser zu einer Entwicklungsretardierung und makroskopisch erkennbaren Missbildungen auch zu Fehlbildungen im Zentralnervensystem. Diese bestehen aus einer Verschmaelerung und Desorganisation des Neocortex sowie dem Auftreten von rosettenfoermigen Zellaggregaten. Letztere sind ab einer Dosis von 3 x 110 R in den dorsalen Hemisphaerenabschnitten zu beobachten und liegen in einem Proliferationsgebiet wenig differenzierter Zellen, welches der dorsalen Ventrikelmatrix kappenartig aufsitzt und sich auch tief in die Ventrikelanlage vorwoelbt. Bis zu einer Dosis von 3 x 120 R sind die Rosetten im Neocortex gut gegeneinander abgegrenzt und anzahl- sowie groessenmaessig erfassbar. Dabei laesst deren geringe Haeufigkeit und Groesse in den mittleren Ventrikelwandabschnitten auf eine hoehere Strahlenresistenz dieser Grosshirnbereiche schliessen. Gleichzeitig kann eine gute Korrelation zwischen Anzahl der Rosetten und der Abnahme der Hemisphaerenwanddicke dargestellt werden. Dies stellte die Voraussetzung fuer eine genaue Studie dar, welche das Ausmass postnataler Reparationsprozesse am Gehirn nach praenatalem Strahleninsult in Fortfuehrung dieser Arbeit behandeln soll. AU - Schmahl, W.G. AU - Kriegel, H. AU - Ostertag, B. C1 - 40959 C2 - 40361 SP - 630-637 TI - Missbildungen des ZNS fetaler Mäuse nach fraktionierter ganzkörper Röntgenbestrahlung. Topographische und quantitative mikrobiologische Charakterisierung. JO - Strahlenther. Onkol. VL - 153 IS - 9 PY - 1977 SN - 0179-7158 ER - TY - JOUR AB - The basis for therapy with fast neutrons is discussed and three fields are considered: The physical field, the physico chemical field, and the biological field. In the physical field no advantages in the dose distribution, in the influence of scattering and in the consideration of inhomogeneities in the irradiated tissue are found. In the physico chemical field, the marked advantage of fast neutrons is an avoidance of the 'oxygen effect', which must be expected under sparsely ionizing radiation. In the biological field one can expect lower reparation under irradiation with fast neutrons than with sparsely ionizing particles. Therefore, the difference in action between tumour and healthy tissue diminishes under fractionated irradiation and calls this to one's attention in practical therapy. AU - Pohlit, W. C1 - 41252 C2 - 35714 SP - 491-503 TI - Physikalische und biologische Grundlagen der Neutronentherapie. JO - Strahlenther. Onkol. VL - 145 IS - 5 PY - 1973 SN - 0179-7158 ER -