@phdthesis{Schramm2008,
  author    = {Schramm, Stefanie},
  title     = {{\"U}berleben und Lebensqualit{\"a}t sprechen f{\"u}r ein konservatives Therapiekonzept bei Patienten mit Magenlymphomen : Ergebnisse einer prospektiven randomisierten Studie},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-30698},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2008},
  abstract  = {Gastrointestinale Lymphome des MALT sind heute als eigenst{\"a}ndige Entit{\"a}t anerkannt. Sie zeichnen sich durch morphologische, molekularbiologische, {\"a}tiopathogenetische und biologische Besonderheiten aus, die sie von den nodalen Lymphomen abgrenzen lassen. Im Rahmen der W{\"u}rzburger Multicenterstudie „Gastrointestinale Lymphome II" soll die Frage gekl{\"a}rt werden, ob in den lokalisierten Stadien I und II prim{\"a}rer Magenlymphome unter Ber{\"u}cksichtigung der posttherapeutischen Lebensqualit{\"a}t der operativen oder einer prim{\"a}r konservativen Therapie (Chemo- oder Radiotherapie) Vorzug gegeben werden soll. Von 1998 bis 2002 wurden dazu 49 Patienten mit neu diagnostiziertem niedrig- (n=19) oder hochmalignen (n=30) NHL des Magens in die Studie eingeschlossen. Nach zentraler Randomisierung wurden die Patienten mit low grade NHL der Operation (n=10) oder der Radiotherapie (n=9) zugeteilt. Die Patienten mit high grade NHL erhielten Operation plus Chemotherapie (n=16) oder alleinige Chemotherapie (n=14). Das mediane follow up betrug 74 Monate. Sowohl das operative als auch das konservative Vorgehen zeigten bei beiden Lymphomhistologien {\"u}beraus hohe Remissionsraten in den Stadien EI und EII (CR um 90\%). Unterschiede zwischen den Behandlungsmethoden konnten, evtl. auch bedingt durch die kleinen Gruppengr{\"o}ßen, nicht nachgewiesen werden. Insgesamt verstarben sechs Patienten, die sich in etwa gleichm{\"a}ßig auf die Gruppen verteilten. Die Auswertung der Frageb{\"o}gen zur Lebensqualit{\"a}t ergab gem{\"a}ß SF-36 durchaus hohe Werte zur posttherapeutischen Lebensqualit{\"a}t. Eine Differenzierung der Patienten nach Behandlungsmethode oder Malignit{\"a}tsgrad (low, high grade) war nicht m{\"o}glich. Der Lebensqualit{\"a}tsindex nach Troidl ließ einen pr{\"a}-post-therapeutischen Vergleich zu: Betrachtet man die Kombination von Therapie und Malignit{\"a}tsgrad, so fallen konservativ therapierte Patienten (unabh{\"a}ngig vom Malignit{\"a}tsgrad) durch deutlich ansteigende Lebensqualit{\"a}t auf. Es l{\"a}sst sich festhalten, dass bei prim{\"a}r gastrointestinalen Lymphomen sowohl mit operativem als auch konservativem Vorgehen hohe Remissionsraten erzielt werden k{\"o}nnen. Jedoch sind im Hinblick auf Organerhalt und die h{\"o}here post-therapeutische Lebensqualit{\"a}t die prim{\"a}re Radio- und/oder Chemotherapie dem operativen Vorgehen vorzuziehen.},
  subject      = {Non-Hodgkin-Lymphom},
  language  = {de}
}
@phdthesis{Mueller2004,
  author    = {M{\"u}ller, Matthias},
  title     = {Vergleich von in-vitro-Ergebnissen im Mikrokerntest und den klinischen Beobachtungen nach Bestrahlung},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-10212},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2004},
  abstract  = {Hintergrund: Mikrokerne sind Chromosomenfragmente, die nicht in den Hauptkern integriert wurden und im Zytoplasma von proliferierenden Zellen nach ionisierender Strahlung oder Behandlung mit mutagensierenden Substanzen zu finden sind. In vielen F{\"a}llen konnte gezeigt werden, dass die Mikrokernfrequenz als Indikator f{\"u}r den strahleninduzierten Schaden dienen kann. Humane Lymphozyten und Fibroblasten von Patientinnen mit Brustkrebs nach Brusterhaltender Therapie wurden bestrahlt, im Mikrokerntest ausgewertet und die Ergebnisse mit den klinischen Akutreaktionen verglichen. Methode: Beide Zelltypen der 24 Patientinnen mit dem selben Bestrahlungsproceder (50 Gy + 10 Gy Boost) und ohne Chemotherapie wurden untersucht. Die Normalgewebsreaktionen wurden unter Verwendung der RTOG-Kriterien bestimmt. Die Zellen wurden in vitro mit 0-, 1-, 2-Gy-Einmaldosis-Bestrahlung (Lymphozyten) bzw. 0-, 2-, 4-Gy-Einmaldosis-Bestrahlung behandelt, {\"u}ber 72 h kultiviert, auf Objekttr{\"a}gern fixiert und bei 400 - 1000facher Vergr{\"o}ßerung (Fluoreszenzmikroskop) ausgewertet. Die Zellteilung der Lymphozyten wurde mittels Cytochalasin B (Cyt B) inhibiert. Ergebnisse: Es konnte keine signifikante Korrelation der in-vitro-Strahlenempfindlichkeit und den Normalgewebsreaktionen beobachtet werden. Des weiteren wurde kein Zusammenhang zwischen der Strahlenempfindlichkeit der lymphozyten und den Fibroblasten, die vom selben Spender gewonnen wurden, beobachtet. Zusammenfassung: Die Daten unterst{\"u}tzen nicht den Nutzen des Mikrokern-Testes in der Vorhersage von Normalgewebsreaktionen auf die Strahlentherapie bei Malignompatienten.},
  language  = {de}
}
@phdthesis{Klingelhoeffer2006,
  author    = {Klingelh{\"o}ffer, Christoph},
  title     = {Untersuchung zur Lebensqualit{\"a}t nach neoadjuvanter Chemotherapie und Radiatio bei fortgeschrittenen Larynx- und Hypopharynxkarzinomen},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-20134},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2006},
  abstract  = {Diese Studie stellt die Lebensqualit{\"a}t und den Gesundheitszustand von Patienten mit einem fortgeschrittenen Larynx- oder Hypopharynxkarzinom nach neoadjuvanter Chemotherapie und Radiatio dar. Hierbei wird auf verschiedene Teilbereiche der Auswirkungen dieser Erkrankung eingegangen, die individuell den Grad der Lebensqualit{\"a}t beeinflussen. Die Werte geben die durchschnittliche Meinung des Patientenkollektivs wieder und k{\"o}nnen somit nur gemeinsame Tendenzen hervorbringen. Die Patienten gaben an, nur eine geringe Minderung ihrer Lebensqualit{\"a}t durch die Erkrankung festzustellen. {\"U}ber 60\% des Patientenkollektivs sch{\"a}tzten ihre Lebensqualit{\"a}t bzw. ihren Gesundheitszustand als sehr gut oder nur wenig beeintr{\"a}chtigt ein. Das Patientenkollektiv best{\"a}tigt durch seinen hohen Nikotin- und Alkoholkonsumenten-anteil die Risikofaktoren f{\"u}r diese Erkrankung. Leider konnte der Großteil der Patienten nicht dazu bewegt werden, das Alkoholgenussverhalten zu {\"u}berdenken und es deutlich zu reduzieren. Die Notwendigkeit, den Nikotinkonsum einzuschr{\"a}nken, wurde eher akzeptiert. Im Hinblick auf die alternative operative Entfernung des Prim{\"a}rtumors und damit des Kehlkopfes, war die erneute Entscheidung f{\"u}r die konservative Therapie f{\"u}r die meisten Patienten eindeutig. Auch die Aufkl{\"a}rung wurde in der Regel positiv bewertet. Der hohe Stellenwert einer erhaltenen Kommunikationsf{\"a}higkeit ist f{\"u}r die Patienten der ausschlaggebende Punkt, sich wieder f{\"u}r diese Therapie zu entscheiden. Das Symptom der Xerostomie bereitet den Patienten die gr{\"o}ßten Schwierigkeiten. Die Auswirkung auf andere Bereiche wie verminderte Gleitf{\"a}higkeit der Speisen, schlechterer Prothesensitz und verst{\"a}rkte Zerkleinerung der Speisen sind hier zu ber{\"u}cksichtigen. Eine erh{\"o}hte psychische Belastung ist die Folge, die auch das Sozialleben der Patienten beeinflusst. Dies zeigte sich vor allem in der Frage nach Genuss von Essen in der Gesellschaft. 44 \% vermieden es, in der {\"O}ffentlichkeit zu essen oder schr{\"a}nkten es zumindest stark ein. H{\"a}ufiger traten Ver{\"a}nderungen der Stimme auf. Sie waren vor allem durch Heiserkeit bedingt. Die Betroffenen wurden jedoch dadurch nur im geringen Maße gest{\"o}rt. Einschr{\"a}nkungen in der Kopf- und Armbewegung stellen sich aufgrund der nichtoperativen Therapie als geringf{\"u}giges Problem dar. Dies tr{\"a}gt dazu bei, dass nur wenige Einschr{\"a}nkungen im Bereich Mobilit{\"a}t bzw. Arbeitsf{\"a}higkeit zu verzeichnen waren. Eine geringere Abh{\"a}ngigkeit von den Angeh{\"o}rigen ist die Folge, was die Selbstst{\"a}ndigkeit der Patienten erh{\"a}lt und gleichzeitig psychische Belastungen abbaut. Andere Symptome wie Schmerzen, Kieferklemme, Entz{\"u}ndungen im Mund- und Rachenraum kommen aufgrund der bereits durchschnittlich l{\"a}ngeren Genesungsphase nur selten vor.},
  language  = {de}
}
@article{TamihardjaLutyjKraftetal.2021,
  author    = {Tamihardja, J{\"o}rg and Lutyj, Paul and Kraft, Johannes and Lisowski, Dominik and Weick, Stefan and Flentje, Michael and Polat, B{\"u}lent},
  title     = {Two-Weekly High-Dose-Rate Brachytherapy Boost After External Beam Radiotherapy for Localized Prostate Cancer: Long-Term Outcome and Toxicity Analysis},
  series = {Frontiers in Oncology},
  volume    = {11},
  journal   = {Frontiers in Oncology},
  issn      = {2234-943X},
  doi       = {10.3389/fonc.2021.764536},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-250992},
  year      = {2021},
  abstract  = {Purpose Evaluation of clinical outcome of two-weekly high-dose-rate brachytherapy boost after external beam radiotherapy (EBRT) for localized prostate cancer. Methods 338 patients with localized prostate cancer receiving definitive EBRT followed by a two-weekly high-dose-rate brachytherapy boost (HDR-BT boost) in the period of 2002 to 2019 were analyzed. EBRT, delivered in 46 Gy (DMean) in conventional fractionation, was followed by two fractions HDR-BT boost with 9 Gy (D90\%) two and four weeks after EBRT. Androgen deprivation therapy (ADT) was added in 176 (52.1\%) patients. Genitourinary (GU)/gastrointestinal (GI) toxicity was evaluated utilizing the Common Toxicity Criteria for Adverse Events (version 5.0) and biochemical failure was defined according to the Phoenix definition. Results Median follow-up was 101.8 months. 15 (4.4\%)/115 (34.0\%)/208 (61.5\%) patients had low-/intermediate-/high-risk cancer according to the D`Amico risk classification. Estimated 5-year and 10-year biochemical relapse-free survival (bRFS) was 84.7\% and 75.9\% for all patients. The estimated 5-year bRFS was 93.3\%, 93.4\% and 79.5\% for low-, intermediate- and high-risk disease, respectively. The estimated 10-year freedom from distant metastasis (FFM) and overall survival (OS) rates were 86.5\% and 70.0\%. Cumulative 5-year late GU toxicity and late GI toxicity grade ≥ 2 was observed in 19.3\% and 5.0\% of the patients, respectively. Cumulative 5-year late grade 3 GU/GI toxicity occurred in 3.6\%/0.3\%. Conclusions Two-weekly HDR-BT boost after EBRT for localized prostate cancer showed an excellent toxicity profile with low GU/GI toxicity rates and effective long-term biochemical control.},
  language  = {en}
}
@article{ElMajdoubHunscheIgressaetal.2015,
  author    = {El Majdoub, Faycal and Hunsche, Stefan and Igressa, Alhadi and Kocher, Martin and Sturm, Volker and Maarouf, Mohammad},
  title     = {Stereotactic LINAC-Radiosurgery for Glomus Jugulare Tumors: A Long-Term Follow-Up of 27 Patients},
  series = {PLoS ONE},
  volume    = {10},
  journal   = {PLoS ONE},
  number    = {6},
  doi       = {10.1371/journal.pone.0129057},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-151717},
  pages     = {e0129057},
  year      = {2015},
  abstract  = {Background The optimal treatment of glomus jugulare tumors (GJTs) remains controversial. Due to the critical location, microsurgery still provides high treatment-related morbidity and a decreased quality of life. Thus, we performed stereotactical radiosurgery (SRS) for the treatment of GJTs and evaluated the long-term outcome. Methods Between 1991 and 2011, 32 patients with GJTs underwent SRS using a linear accelerator (LINAC) either as primary or salvage therapy. Twenty-seven patients (median age 59.9 years, range 28.7-79.9 years) with a follow-up greater than five years (median 11 years, range 5.3-22.1 years) were selected for retrospective analysis. The median therapeutic single dose applied to the tumor surface was 15 Gy (range 11-20 Gy) and the median tumor volume was 9.5 ml (range 2.8-51 ml). Results Following LINAC-SRS, 10 of 27 patients showed a significant improvement of their previous neurological complaints, whereas 12 patients remained unchanged. Five patients died during follow-up due to old age or other, not treatment-related reasons. MR-imaging showed a partial remission in 12 and a stable disease in 15 patients. No tumor progression was observed. The actuarial overall survival rates after five, ten and 20 years were 100\%, 95.2\% and 79.4\%, respectively. Conclusions Stereotactic LINAC-Radiosurgery can achieve an excellent long-term tumor control beside a low rate of morbidity in the treatment of GJTs. It should be considered as an alternative therapy regime to surgical resection or fractionated external beam radiation either as primary, adjuvant or salvage therapy.},
  language  = {en}
}
@article{BratengeierHolubyevWegener2019,
  author    = {Bratengeier, Klaus and Holubyev, Kostyantyn and Wegener, Sonja},
  title     = {Steeper dose gradients resulting from reduced source to target distance—a planning system independent study},
  series = {Journal of Applied Clinical Medical Physics},
  volume    = {20},
  journal   = {Journal of Applied Clinical Medical Physics},
  number    = {1},
  doi       = {10.1002/acm2.12490},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-177424},
  pages     = {89-100},
  year      = {2019},
  abstract  = {Purpose: To quantify the contribution of penumbra in the improvement of healthy tissue sparing at reduced source-to-axis distance (SAD) for simple spherical target and different prescription isodoses (PI). Method: A TPS-independent method was used to estimate three-dimensional (3D) dose distribution for stereotactic treatment of spherical targets of 0.5 cm radius based on single beam two-dimensional (2D) film dosimetry measurements. 1 cm target constitutes the worst case for the conformation with standard Multi-Leaf Collimator (MLC) with 0.5 cm leaf width. The measured 2D transverse dose cross-sections and the profiles in leaf and jaw directions were used to calculate radial dose distribution from isotropic beam arrangement, for both quadratic and circular beam openings, respectively. The results were compared for standard (100 cm) and reduced SAD 70 and 55 cm for different PI. Results: For practical reduction of SAD using quadratic openings, the improvement of healthy tissue sparing (HTS) at distances up to 3 times the PTV radius was at least 6\%-12\%; gradient indices (GI) were reduced by 3-39\% for PI between 40\% and 90\%. Except for PI of 80\% and 90\%, quadratic apertures at SAD 70 cm improved the HTS by up to 20\% compared to circular openings at 100 cm or were at least equivalent; GI were 3\%-33\% lower for reduced SAD in the PI range 40\%-70\%. For PI = 80\% and 90\% the results depend on the circular collimator model. Conclusion: Stereotactic treatments of spherical targets delivered at reduced SAD of 70 or 55 cm using MLC spare healthy tissue around the target at least as good as treatments at SAD 100 cm using circular collimators. The steeper beam penumbra at reduced SAD seems to be as important as perfect target conformity. The authors argue therefore that the beam penumbra width should be addressed in the stereotactic studies.},
  language  = {en}
}
@article{WiegeringRiedmeierThompsonetal.2022,
  author    = {Wiegering, Verena and Riedmeier, Maria and Thompson, Lester D. R. and Virgone, Calogero and Redlich, Antje and Kuhlen, Michaela and Gultekin, Melis and Yalcin, Bilgehan and Decarolis, Boris and H{\"a}rtel, Christoph and Schlegel, Paul-Gerhardt and Fassnacht, Martin and Timmermann, Beate},
  title     = {Radiotherapy for pediatric adrenocortical carcinoma - Review of the literature},
  series = {Clinical and Translational Radiation Oncology},
  volume    = {35},
  journal   = {Clinical and Translational Radiation Oncology},
  doi       = {10.1016/j.ctro.2022.05.003},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300472},
  pages     = {56-63},
  year      = {2022},
  abstract  = {Background and purpose Pediatric adrenocortical carcinoma (pACC) is a rare disease with poor prognosis. Publications on radiotherapy (RT) are scarce. This review summarizes the current data on RT for pACC and possibly provides first evidence to justify its use in this setting. Materials and methods We searched the PubMed and Embase database for manuscripts regarding RT for pACC. Results We included 17 manuscripts reporting on 76 patients treated with RT, after screening 2961 references and 269 full articles. In addition, we added data of 4 unreported pACC patients treated by co-authors. All reports based on retrospective data. Median age at first diagnosis was 11.1 years (70\% female); 78\% of patients presented with hormonal activity. RT was mostly performed for curative intent (78\%). 88\% of RT were administered during primary therapy. The site of RT was predominantly the local tumor bed (76\%). Doses of RT ranged from 15 to 62 Gy (median 50 Gy). Information on target volumes or fractionation were lacking. Median follow-up was 6,9 years and 64\% of the patients died of disease, with 33\% alive without disease. In 16 of 48 patients with available follow-up data after adjuvant RT (33\%) no recurrence was reported and in 3 of 9 patients palliative RT seemed to induce some benefit for the patient. Conclusions Our first systematic review on RT for pACC provides too few data for any general recommendation, but adjuvant RT in patients with high risk might be considered. International collaborative studies are urgently needed to establish better evidence on the role of RT in this rare malignancy.},
  language  = {en}
}
@article{vanOorschotBeckmannSchulzeetal.2011,
  author    = {van Oorschot, Birgitt and Beckmann, Gabriele and Schulze, Wolfgang and Rades, Dirk and Feyer, Petra},
  title     = {Radiotherapeutic options for symptom control in breast cancer},
  series = {Breast Care},
  volume    = {6},
  journal   = {Breast Care},
  number    = {1},
  issn      = {1661-3791},
  doi       = {10.1159/000324564},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-199105},
  pages     = {14-19},
  year      = {2011},
  abstract  = {The majority of breast cancer patients will require radiation therapy at some time during the course of their disease. An estimated 30-50\% of all radiation treatments are of palliative nature, either to alleviate symptoms or prophylactic to prevent deterioration of quality of life due to locally progressive disease. Radiotherapy is a locally effective tool, and typically causes no systemic and mostly mild acute side effects. The following article provides an overview of options and decision-making in palliative radiotherapy for symptom control.},
  language  = {en}
}
@article{FischerHartmannReisslandetal.2022,
  author    = {Fischer, Thomas and Hartmann, Oliver and Reissland, Michaela and Prieto-Garcia, Cristian and Klann, Kevin and Pahor, Nikolett and Sch{\"u}lein-V{\"o}lk, Christina and Baluapuri, Apoorva and Polat, B{\"u}lent and Abazari, Arya and Gerhard-Hartmann, Elena and Kopp, Hans-Georg and Essmann, Frank and Rosenfeldt, Mathias and M{\"u}nch, Christian and Flentje, Michael and Diefenbacher, Markus E.},
  title     = {PTEN mutant non-small cell lung cancer require ATM to suppress pro-apoptotic signalling and evade radiotherapy},
  series = {Cell \& Bioscience},
  volume    = {12},
  journal   = {Cell \& Bioscience},
  issn      = {2045-3701},
  doi       = {10.1186/s13578-022-00778-7},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-299865},
  year      = {2022},
  abstract  = {Background Despite advances in treatment of patients with non-small cell lung cancer, carriers of certain genetic alterations are prone to failure. One such factor frequently mutated, is the tumor suppressor PTEN. These tumors are supposed to be more resistant to radiation, chemo- and immunotherapy. Results We demonstrate that loss of PTEN led to altered expression of transcriptional programs which directly regulate therapy resistance, resulting in establishment of radiation resistance. While PTEN-deficient tumor cells were not dependent on DNA-PK for IR resistance nor activated ATR during IR, they showed a significant dependence for the DNA damage kinase ATM. Pharmacologic inhibition of ATM, via KU-60019 and AZD1390 at non-toxic doses, restored and even synergized with IR in PTEN-deficient human and murine NSCLC cells as well in a multicellular organotypic ex vivo tumor model. Conclusion PTEN tumors are addicted to ATM to detect and repair radiation induced DNA damage. This creates an exploitable bottleneck. At least in cellulo and ex vivo we show that low concentration of ATM inhibitor is able to synergise with IR to treat PTEN-deficient tumors in genetically well-defined IR resistant lung cancer models.},
  language  = {en}
}
@article{GreberPolatFlentjeetal.2019,
  author    = {Greber, Johannes and Polat, B{\"u}lent and Flentje, Michael and Bratengeier, Klaus},
  title     = {Properties of the anisotropy of dose contributions: A planning study on prostate cases},
  series = {Medical Physics},
  volume    = {46},
  journal   = {Medical Physics},
  doi       = {10.1002/mp.13308},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-228237},
  pages     = {419-425},
  year      = {2019},
  abstract  = {Purpose To characterize the static properties of the anisotropy of dose contributions for different treatment techniques on real patient data (prostate cases). From this, we aim to define a class of treatment techniques with invariant anisotropy distribution carrying information of target coverage and organ-at-risk (OAR) sparing. The anisotropy presumably is a helpful quantity for plan adaptation problems. Methods The anisotropy field is analyzed for different intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) techniques for a total of ten planning CTs of prostate cases. Primary irradiation directions ranged from 5 to 15. The uniqueness of anisotropy was explored: In particular, the anisotropy distribution inside the planning treatment volume (PTV) and in its vicinity was investigated. Furthermore, deviations of the anisotropy under beam rotations were explored by direct plan comparison as an indicating the susceptibility of each planned technique to changes in the geometric plan configuration. In addition, plan comparisons enabled the categorization of treatment techniques in terms of their anisotropy distribution. Results The anisotropy profile inside the PTV and in the transition between OAR and PTV is independent of the treatment technique as long as a sufficient number of beams contribute to the dose distribution. Techniques with multiple beams constitute a class of almost identical and technique-independent anisotropy distribution. For this class of techniques, substructures of the anisotropy are particularly pronounced in the PTV, thus offering good options for applying adaptation rules. Additionally, the techniques forming the mentioned class fortunately allow a better OAR sparing at constant PTV coverage. Besides the characterization of the distribution, a pairwise plan comparison reveals each technique's susceptibility to deviations which decreases for an increasing number of primary irradiation directions. Conclusions Techniques using many irradiation directions form a class of almost identical anisotropy distributions which are assumed to provide a basis for improved adaptation procedures. Encouragingly, these techniques deliver quite invariant anisotropy distributions with respect to rotations correlated with good plan qualities than techniques using few gantry angles. The following will be the next steps toward anisotropy-based adaptation: first, the quantification of anisotropy regarding organ deformations; and second, establishing the interrelation between the anisotropy and beam shaping.},
  language  = {en}
}