@article{TamihardjaSchortmannLawrenzetal.2021, author = {Tamihardja, J{\"o}rg and Schortmann, Max and Lawrenz, Ingulf and Weick, Stefan and Bratengeier, Klaus and Flentje, Michael and Guckenberger, Matthias and Polat, B{\"u}lent}, title = {Moderately hypofractionated radiotherapy for localized prostate cancer: updated long-term outcome and toxicity analysis}, series = {Strahlentherapie und Onkologie}, volume = {197}, journal = {Strahlentherapie und Onkologie}, issn = {0179-7158}, doi = {10.1007/s00066-020-01678-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232509}, pages = {124-132}, year = {2021}, abstract = {Purpose Evaluation of long-term outcome and toxicity of moderately hypofractionated radiotherapy using intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost treatment planning and cone beam CT-based image guidance for localized prostate cancer. Methods Between 2005 and 2015, 346 consecutive patients with localized prostate cancer received primary radiotherapy using cone beam CT-based image-guided intensity-modulated radiotherapy (IG-IMRT) and volumetric modulated arc therapy (IG-VMAT) with a simultaneous integrated boost (SIB). Total doses of 73.9 Gy (n = 44) and 76.2 Gy (n = 302) to the high-dose PTV were delivered in 32 and 33 fractions, respectively. The low-dose PTV received a dose (D95) of 60.06 Gy in single doses of 1.82 Gy. The pelvic lymph nodes were treated in 91 high-risk patients to 45.5 Gy (D95). Results Median follow-up was 61.8 months. The 5‑year biochemical relapse-free survival (bRFS) was 85.4\% for all patients and 93.3, 87.4, and 79.4\% for low-, intermediate-, and high-risk disease, respectively. The 5‑year prostate cancer-specific survival (PSS) was 94.8\% for all patients and 98.7, 98.9, 89.3\% for low-, intermediate-, and high-risk disease, respectively. The 5‑year and 10-year overall survival rates were 83.8 and 66.3\% and the 5‑year and 10-year freedom from distant metastasis rates were 92.2 and 88.0\%, respectively. Cumulative 5‑year late GU toxicity and late GI toxicity grade ≥2 was observed in 26.3 and 12.1\% of the patients, respectively. Cumulative 5‑year late grade 3 GU/GI toxicity occurred in 4.0/1.2\%. Conclusion Moderately hypofractionated radiotherapy using SIB treatment planning and cone beam CT image guidance resulted in high biochemical control and survival with low rates of late toxicity.}, language = {en} } @article{MantelMuellerKleineetal.2021, author = {Mantel, Frederick and M{\"u}ller, Elena and Kleine, Philip and Zimmermann, Marcus and Exner, Florian and Richter, Anne and Weick, Stefan and Str{\"o}hle, Serge and Polat, B{\"u}lent and H{\"o}cht, Stefan and Flentje, Michael}, title = {Chemoradiotherapy by intensity-modulated radiation therapy with simultaneous integrated boost in locally advanced or oligometastatic non-small-cell lung cancer-a two center experience}, series = {Strahlentherapie und Onkologie}, volume = {197}, journal = {Strahlentherapie und Onkologie}, number = {5}, issn = {1439-099X}, doi = {10.1007/s00066-021-01756-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-264821}, pages = {405-415}, year = {2021}, abstract = {Purpose Integrating moderate hypofractionation to the macroscopic tumor with elective nodal irradiation while sparing the organs at risk (OAR) in chemoradiotherapy of locally advanced non-small-cell lung cancer. Methods From 2010-2018, treatment, patient and tumor characteristics of 138 patients from two radiation therapy centers were assessed. Chemoradiotherapy by intensity-modulated radiation therapy (IMRT) with a simultaneous integrated boost (SIB) to the primary tumor and macroscopic lymph node metastases was used. Results A total of 124 (90\%) patients received concurrent chemotherapy. 106 (76\%) patients had UICC (Union for International Cancer Control) stage ≥IIIB and 21 (15\%) patients had an oligometastatic disease (UICC stage IV). Median SIB and elective total dose was 61.6 and 50.4 Gy in 28 fractions, respectively. Furthermore, 64 patients (46\%) had an additional sequential boost to the primary tumor after the SIB-IMRT main series: median 6.6 Gy in median 3 fractions. The median cumulative mean lung dose was 15.6 Gy (range 6.2-29.5 Gy). Median follow-up and radiological follow-up for all patients was 18.0 months (range 0.6-86.9) and 16.0 months (range 0.2-86.9), respectively. Actuarial local control rates at 1, 2 and 3 years were 80.4, 68.4 and 57.8\%. Median overall survival and progression-free survival was 30.0 months (95\% confidence interval [CI] 23.5-36.4) and 12.1 months (95\% CI 8.2-16.0), respectively. Treatment-related toxicity was moderate. Radiation-induced pneumonitis grade 2 and grade 3 occurred in 13 (9.8\%) and 3 (2.3\%) patients. Conclusions Chemoradiotherapy using SIB-IMRT showed promising local tumor control rates and acceptable toxicity in patients with locally advanced and in part oligometastatic lung cancer. The SIB concept, resulting in a relatively low mean lung dose, was associated with low numbers of clinically relevant pneumonitis. The overall survival appears promising in the presence of a majority of patients with UICC stage ≥IIIB disease.}, language = {en} }