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Gkika E, Kostyszyn D, Fechter T, Moustakis C, Ernst F, Boda-Heggemann J, Sarria G, Dieckmann K, Dobiasch S, Duma MN, Eberle F, Kroeger K, Häussler B, Izaguirre V, Jazmati D, Lautenschläger S, Lohaus F, Mantel F, Menzel J, Pachmann S, Pavic M, Radlanski K, Riesterer O, Gerum S, Röder F, Willner J, Barczyk S, Imhoff D, Blanck O, Wittig A, Guckenberger M, Grosu AL, Brunner TB. Interobserver agreement on definition of the target volume in stereotactic radiotherapy for pancreatic adenocarcinoma using different imaging modalities. Strahlenther Onkol 2023; 199:973-981. [PMID: 37268767 PMCID: PMC10598103 DOI: 10.1007/s00066-023-02085-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/11/2023] [Indexed: 06/04/2023]
Abstract
PURPOSE The aim of this study was to evaluate interobserver agreement (IOA) on target volume definition for pancreatic cancer (PACA) within the Radiosurgery and Stereotactic Radiotherapy Working Group of the German Society of Radiation Oncology (DEGRO) and to identify the influence of imaging modalities on the definition of the target volumes. METHODS Two cases of locally advanced PACA and one local recurrence were selected from a large SBRT database. Delineation was based on either a planning 4D CT with or without (w/wo) IV contrast, w/wo PET/CT, and w/wo diagnostic MRI. Novel compared to other studies, a combination of four metrics was used to integrate several aspects of target volume segmentation: the Dice coefficient (DSC), the Hausdorff distance (HD), the probabilistic distance (PBD), and the volumetric similarity (VS). RESULTS For all three GTVs, the median DSC was 0.75 (range 0.17-0.95), the median HD 15 (range 3.22-67.11) mm, the median PBD 0.33 (range 0.06-4.86), and the median VS was 0.88 (range 0.31-1). For ITVs and PTVs the results were similar. When comparing the imaging modalities for delineation, the best agreement for the GTV was achieved using PET/CT, and for the ITV and PTV using 4D PET/CT, in treatment position with abdominal compression. CONCLUSION Overall, there was good GTV agreement (DSC). Combined metrics appeared to allow a more valid detection of interobserver variation. For SBRT, either 4D PET/CT or 3D PET/CT in treatment position with abdominal compression leads to better agreement and should be considered as a very useful imaging modality for the definition of treatment volumes in pancreatic SBRT. Contouring does not appear to be the weakest link in the treatment planning chain of SBRT for PACA.
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Affiliation(s)
- E Gkika
- Department of Radiation Oncology, University Medical Center Freiburg, Robert Koch Str 3, Freiburg, Germany.
| | - D Kostyszyn
- Department of Radiation Oncology, University Medical Center Freiburg, Robert Koch Str 3, Freiburg, Germany
| | - T Fechter
- Department of Radiation Oncology, University Medical Center Freiburg, Robert Koch Str 3, Freiburg, Germany
| | - C Moustakis
- Department of Radiation Oncology, University Medical Center Muenster, Muenster, Germany
| | - F Ernst
- Institute for Robotics and Cognitive Systems, University of Luebeck, Luebeck, Germany
| | - J Boda-Heggemann
- Department of Radiation Oncology, Faculty of Medicine Mannheim, Department of Radiation Oncology, University of Heidelberg, Mannheim, Germany
| | - G Sarria
- Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany
| | - K Dieckmann
- Department of Radiation Oncology, University Departments of the MedUni Vienna, Vienna General Hospital, Vienna, Austria
| | - S Dobiasch
- Department of Radiation Oncology, Klinikum Rechts der Isar, TU Munich, Munich, Germany
| | - M N Duma
- Department of Radiotherapy and Radiation Oncology, University Hospital Jena, Friedrich-Schiller University, Jena, Germany
| | - F Eberle
- Department of Radiation Oncology, University Hospital Marburg, Marburg, Germany
| | - K Kroeger
- Department of Radiation Oncology, University Medical Center Muenster, Muenster, Germany
| | - B Häussler
- Radiation Oncology Dr. Häussler/Dr. Schorer, Munich, Germany
| | - V Izaguirre
- Department of Radiation Oncology, University Hospital Halle, Halle, Germany
| | - D Jazmati
- Proton Therapy Centre, University Hospital Essen, Essen, Germany
| | - S Lautenschläger
- Department of Radiation Oncology, University Hospital, Marburg, Germany
| | - F Lohaus
- Department of Radiation Oncology, University Hospital Dresden, Dresden, Germany
| | - F Mantel
- Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany
| | - J Menzel
- Department of Radiation Oncology, University Hospital Hannover, Hannover, Germany
| | - S Pachmann
- Department of Radiation Oncology, Weilheim Clinic, Weilheim, Germany
| | - M Pavic
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - K Radlanski
- Department of Radiation Oncology, Charite, University Hospital Berlin, Berlin, Germany
| | - O Riesterer
- Centre for Radiation Oncology KSA-KSB, Kantonsspital Aarau, Aarau, Switzerland
| | - S Gerum
- Department of Radiation Oncology, University Clinic, Paracelsus Medical University (PMU), Salzburg, Austria
| | - F Röder
- Department of Radiation Oncology, University Clinic, Paracelsus Medical University (PMU), Salzburg, Austria
| | - J Willner
- Department of Radiation Oncology, University Hospital Bayreuth, Bayreuth, Germany
| | - S Barczyk
- Center for Radiation Oncology, Belegklinik am St. Agnes-Hospital, Bocholt, Germany
| | - D Imhoff
- Department of Radiation Oncology, Saphir Radiosurgery, University Hospital Frankfurt, Frankfurt, Germany
| | - O Blanck
- Saphir Radiosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - A Wittig
- Department of Radiotherapy and Radiation Oncology, University Hospital Jena, Friedrich-Schiller University, Jena, Germany
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Anca-L Grosu
- Department of Radiation Oncology, University Medical Center Freiburg, Robert Koch Str 3, Freiburg, Germany
| | - T B Brunner
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, Graz, Austria
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Rogers S, Baumert B, Blanck O, Böhmer D, Boström J, Engenhart-Cabillic R, Ermis E, Exner S, Guckenberger M, Habermehl D, Hemmatazad H, Henke G, Lohaus F, Lux S, Mai S, Minasch D, Rezazadeh A, Steffal C, Temming S, Wittig A, Zweifel C, Riesterer O, Combs SE. Correction to: Stereotactic radiosurgery and radiotherapy for resected brain metastases: current pattern of care in the Radiosurgery and Stereotactic Radiotherapy Working Group of the German Association for Radiation Oncology (DEGRO). Strahlenther Onkol 2023; 199:113-114. [PMID: 36374315 DOI: 10.1007/s00066-022-02021-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- S Rogers
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland.
| | - B Baumert
- Kantonsspital Graubünden, 7000, Chur, Switzerland
| | - O Blanck
- Campus Kiel, Universitätsklinikum Schleswig-Holstein, 24105, Kiel, Germany
| | - D Böhmer
- Campus Benjamin Franklin, Charite University Medicine, 12203, Berlin, Germany
| | - J Boström
- Gamma Knife Zentrum, 44892, Bochum, Germany
| | | | - E Ermis
- Bern University Hospital (Inselspital), 3010, Bern, Switzerland
| | - S Exner
- Strahlenzentrum Hamburg, 22419, Hamburg, Germany
| | | | | | - H Hemmatazad
- Bern University Hospital (Inselspital), 3010, Bern, Switzerland
| | - G Henke
- Kantonsspital St. Gallen, 9000, St Gallen, Switzerland
| | - F Lohaus
- University Hospital Dresden, 01307, Dresden, Germany
| | - S Lux
- Radprax Strahlentherapie, 42697, Solingen, Germany
| | - S Mai
- Universitätsmedizin Mannheim, 68167, Mannheim, Germany
| | - D Minasch
- University Hospital Innsbruck, 6020, Innsbruck, Austria
| | - A Rezazadeh
- University Hospital of Cologne, 50937, Cologne, Germany
| | - C Steffal
- KFJ/SMZ-Süd Vienna, Klinik Favoriten, 1100, Vienna, Austria
| | - S Temming
- Robert Janker Klinik, 53129, Bonn, Germany
| | - A Wittig
- University Hospital Jena, 07743, Jena, Germany
| | - C Zweifel
- Kantonsspital Graubünden, 7000, Chur, Switzerland
| | - O Riesterer
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - S E Combs
- Kinik an der Isaar, Technisches Universität München, Munich, Germany
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Rogers S, Baumert B, Blanck O, Böhmer D, Boström J, Engenhart-Cabillic R, Ermis E, Exner S, Guckenberger M, Habermehl D, Hemmatazad H, Henke G, Lohaus F, Lux S, Mai S, Minasch D, Rezazadeh A, Steffal C, Temming S, Wittig A, Zweifel C, Riesterer O, Combs S. Stereotactic radiosurgery and radiotherapy for resected brain metastases: current pattern of care in the Radiosurgery and Stereotactic Radiotherapy Working Group of the German Association for Radiation Oncology (DEGRO). Strahlenther Onkol 2022; 198:919-925. [PMID: 36006436 DOI: 10.1007/s00066-022-01991-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/17/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Preoperative stereotactic radiosurgery (SRS) of brain metastases may achieve similar local control and better leptomeningeal control rates than postoperative fractionated stereotactic radiotherapy (FSRT) in patients treated with elective metastasectomy. To plan a multicentre trial of preoperative SRS compared with postoperative FSRT, a survey of experts was conducted to determine current practice. METHODS A survey with 15 questions was distributed to the DEGRO Radiosurgery and Stereotactic Radiotherapy Working Group. Participants were asked under what circumstances they offered SRS, FSRT, partial and/or whole brain radiotherapy before or after resection of a brain metastasis, as well as the feasibility of preoperative stereotactic radiosurgery and neurosurgical resection within 6 days. RESULTS Of 25 participants from 24 centres, 22 completed 100% of the questions. 24 respondents were radiation oncologists and 1 was a neurosurgeon. All 24 centres have one or more dedicated radiosurgery platform and all offer postoperative FSRT. Preoperative SRS is offered by 4/24 (16.7%) centres, and 9/24 (37.5%) sometimes recommend single-fraction postoperative SRS. Partial brain irradiation is offered by 8/24 (33.3%) centres and 12/24 (50%) occasionally recommend whole-brain irradiation. Two centres are participating in clinical trials of preoperative SRS. SRS techniques and fractionation varied between centres. CONCLUSION All responding centres currently offer postoperative FSRT after brain metastasectomy. Approximately one third offer single-fraction postoperative SRS and four already perform preoperative SRS. With regard to potential co-investigators, 18 were identified for the PREOP‑2 multicentre trial, which will randomise between preoperative SRS and postoperative FSRT.
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Affiliation(s)
- S Rogers
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland.
| | - B Baumert
- Kantonsspital Graubünden, 7000, Chur, Switzerland
| | - O Blanck
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, 24105, Kiel, Germany
| | - D Böhmer
- Charite University Medicine, Campus Benjamin Franklin, 12203, Berlin, Germany
| | - J Boström
- Gamma Knife Zentrum, 44892, Bochum, Germany
| | | | - E Ermis
- Bern University Hospital (Inselspital), 3010, Bern, Switzerland
| | - S Exner
- Strahlenzentrum Hamburg, 22419, Hamburg, Germany
| | | | | | - H Hemmatazad
- Bern University Hospital (Inselspital), 3010, Bern, Switzerland
| | - G Henke
- Kantonsspital St. Gallen, 9000, St Gallen, Switzerland
| | - F Lohaus
- University Hospital Dresden, 01307, Dresden, Germany
| | - S Lux
- Radprax Strahlentherapie, 42697, Solingen, Germany
| | - S Mai
- Universitätsmedizin Mannheim, 68167, Mannheim, Germany
| | - D Minasch
- University Hospital Innsbruck, 6020, Innsbruck, Austria
| | - A Rezazadeh
- University Hospital of Cologne, 50937, Cologne, Germany
| | - C Steffal
- KFJ/SMZ-Süd Vienna; Klinik Favoriten, 1100, Vienna, Austria
| | - S Temming
- Robert Janker Klinik, 53129, Bonn, Germany
| | - A Wittig
- University Hospital Jena, 07743, Jena, Germany
| | - C Zweifel
- Kantonsspital Graubünden, 7000, Chur, Switzerland
| | - O Riesterer
- Radio-Onkologie-Zentrum KSA-KSB, Kantonsspital Aarau, 5001, Aarau, Switzerland
| | - S Combs
- Kinik an der Isaar, Technisches Universität München, Munich, Germany
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Patil S, Linge A, Hiepe H, Grosser M, Lohaus F, Gudziol V, Nowak A, Tinhofer I, Budach V, Guberina M, Stuschke M, Balermpas P, Rödel C, Schäfer H, Grosu A, Abdollahi A, Debus J, Belka C, Pigorsch S, Combs S, Boeke S, Zips D, Baumann M, Krause M, Löck S. MO-0139 PORT-C improves LRC in a subset of patients with intermediate-risk HNSCC: A matched pair analysis. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02299-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rabasco A, Zwanenburg A, Linge A, Lohaus F, Grosser M, Baretton G, Kalinauskaite G, Tinhofer I, Guberina N, Guberina M, Balermpas P, von der Grün J, Ganswindt U, Belka C, Peecken J, Combs S, Böcke S, Zips D, Baumann M, Troost E, Krause M, Löck S. OC-0638 Integrated radiogenomics analyses for outcome prognosis in patients with locally advanced HNSCC. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06994-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kroeze S, Schaule J, Spaas M, Kahl K, Verhoeff J, Schneiders F, Blanck O, Lohaus F, Rogers S, Kaul D, Benavente S, Combs S, Skazikis G, Baumann K, Popp I, Koppe F, Geinitz H, de Jaeger K, Siva S, Stera S, Wittig-Sauerwein A, Lewitzki V, Eckert F, Schymalla M, Guckenberger M. OC-0626 Toxicity of SRT combined with targeted agents: prospective analysis of the TOaSTT database. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06982-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Klusa D, Lohaus F, Neubauer H, Franken A, Rivandi M, Polzer B, Husman D, Kücken M, Hölscher T, Kurth I, Krause M, Dubrovska A, Baumann M, Peitzsch C. PD-0835 Bone-tropic circulating tumor cell population in mCRPC patients under ablative radiotherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07114-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hölscher T, Baumann M, Kotzerke J, Wirth M, Thomas C, Zips D, Löck S, Krause M, Lohaus F. PO-1332 OLI-P trial: pattern of progression after radiotherapy in PSMA-PET positive METs of prostate cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07783-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kroeze S, Fritz C, Blanck O, Kahl K, Kaul D, Siva S, Gerum S, Claes A, Sundahl N, Adebahr S, Nateghian A, Schymalla M, Wittig A, Buergy D, Geier M, Szuecs M, Lohaus F, Henke G, Combs S, Guckenberger M. OC-0453: Efficacy and safety of stereotactic radiotherapy combined with TKIs for metastatic lesions. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00475-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Patil S, Linge A, Tawk B, Gurtner K, Großer M, Lohaus F, Gudziol V, Nowak A, Tinhofer I, Budach V, Stuschke M, Balermpas P, Rödel C, Schäfer H, Grosu A, Abdollahi A, Debus J, Belka C, Combs S, Mönnich D, Zips D, Baretton G, Krause M, Baumann M, Löck S. OC-0570: Validating gene signatures in locally advanced HNSCC patients treated by PORT-C and in xenografts. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00592-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Heitmann J, Kroeze S, Blanck O, Kahl K, Gerum S, Combs S, Kaul D, Claes A, Schymalla M, Grosu A, Eckert F, Lohaus F, Abbasi-Senger N, Henke G, Szuecs M, Geier M, Sundahl N, Buergy D, Guckenberger M. OC-0275 Safety and efficacy of concurrent SRT and targeted- or immunotherapy for melanoma brain metastases. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30695-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Thiele J, Schneider S, Valentini C, Lohaus F, Sarah S, Haak D, Krause M, Hoffmann A, Troost E. PO-1094 Use of an individual abdominal corset in patients with upper-GI tumors treated with proton therapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31514-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kroeze S, Fritz C, Kaul D, Blanck O, Kahl K, Roeder F, Siva S, Verhoeff J, Grosu A, Schymalla M, Glatzer M, Szücs M, Geier M, Mose S, Sackerer I, Lohaus F, Eckert F, Guckenberger M. OC-0059 Stereotactic radiotherapy for oligoprogressive NSCLC: clinical scenarios affecting survival. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30479-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Starke S, Leger S, Zwanenburg A, Pilz K, Lohaus F, Linge A, Zöphel K, Kotzerke J, Schreiber A, Tinhofer I, Budach V, Stuschke M, Balermpas P, Rödel C, Ganswindt U, Belka C, Pigorsch S, Combs S, Mönnich D, Zips D, Krause M, Baumann M, Richter C, Troost E, Löck S. OC-0496 Deep-learning based estimation of locoregional control for patients with locally advanced HNSCC. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30916-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kroeze S, Fritz C, Kaul D, Blanck O, Kahl K, Roeder F, Siva S, Verhoeff J, Grosu A, Schymalla M, Glatzer M, Szuecs M, Geier M, Skazikis G, Sackerer I, Lohaus F, Eckert F, Guckenberger M. Stereotactic radiotherapy concurrent to immune or targeted therapy for oligometastatic NSCLC: Clinical scenarios affecting survival. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz063.071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Klement RJ, Abbasi-Senger N, Adebahr S, Alheid H, Allgaeuer M, Becker G, Blanck O, Boda-Heggemann J, Brunner T, Duma M, Eble MJ, Ernst I, Gerum S, Habermehl D, Hass P, Henkenberens C, Hildebrandt G, Imhoff D, Kahl H, Klass ND, Krempien R, Lewitzki V, Lohaus F, Ostheimer C, Papachristofilou A, Petersen C, Rieber J, Schneider T, Schrade E, Semrau R, Wachter S, Wittig A, Guckenberger M, Andratschke N. The impact of local control on overall survival after stereotactic body radiotherapy for liver and lung metastases from colorectal cancer: a combined analysis of 388 patients with 500 metastases. BMC Cancer 2019; 19:173. [PMID: 30808323 PMCID: PMC6390357 DOI: 10.1186/s12885-019-5362-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 02/11/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The aim of this analysis was to model the effect of local control (LC) on overall survival (OS) in patients treated with stereotactic body radiotherapy (SBRT) for liver or lung metastases from colorectal cancer. METHODS The analysis is based on pooled data from two retrospective SBRT databases for pulmonary and hepatic metastases from 27 centers from Germany and Switzerland. Only patients with metastases from colorectal cancer were considered to avoid histology as a confounding factor. An illness-death model was employed to model the relationship between LC and OS. RESULTS Three hundred eighty-eight patients with 500 metastatic lesions (lung n = 209, liver n = 291) were included and analyzed. Median follow-up time for local recurrence assessment was 12.1 months. Ninety-nine patients with 112 lesions experienced local failure. Seventy-one of these patients died after local failure. Median survival time was 27.9 months in all patients and 25.4 months versus 30.6 months in patients with and without local failure after SBRT. The baseline risk of death after local failure exceeds the baseline risk of death without local failure at 10 months indicating better survival with LC. CONCLUSION In CRC patients with lung or liver metastases, our findings suggest improved long-term OS by achieving metastatic disease control using SBRT in patients with a projected OS estimate of > 12 months.
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Affiliation(s)
- Rainer J Klement
- Department of Radiation Oncology, Leopoldina Hospital Schweinfurt, Schweinfurt, Germany
| | - N Abbasi-Senger
- Department of Radiation Oncology, University Hospital Jena, Jena, Germany
| | - S Adebahr
- Department of Radiation Oncology, University Hospital Freiburg, Freiburg, Germany
| | - H Alheid
- Strahlentherapie Bautzen, Bautzen, Germany
| | - M Allgaeuer
- Department of Radiation Oncology, Hospital Barmherzige Brueder, Regensburg, Germany
| | - G Becker
- RadioChirurgicum CyberKnife Suedwest, Goeppingen, Germany
| | - O Blanck
- Department of Radiation Oncology Universitaetsklinikum Schleswig-Holstein, Luebeck, Germany
| | - J Boda-Heggemann
- Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - T Brunner
- Department of Radiation Oncology, University Hospital Freiburg, Freiburg, Germany
| | - M Duma
- Department of Radiation Oncology, Klinikum rechts der Isar- Technische Universitaet Muenchen, Munich, Germany
| | - M J Eble
- Department of Radiation Oncology, University Hospital Aachen, Aachen, Germany
| | - I Ernst
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - S Gerum
- Department of Radiation Oncology, Ludwig Maximilians University Munich, Munich, Germany
| | - D Habermehl
- Department of Radiation Oncology, Klinikum rechts der Isar- Technische Universitaet Muenchen, Munich, Germany.,Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - P Hass
- Department of Radiation Oncology, University Hospital Magdeburg, Magdeburg, Germany
| | - C Henkenberens
- Department of Radiotherapy and Special Oncology, Medical School Hannover, Hanover, Germany
| | - G Hildebrandt
- Department of Radiation Oncology, University of Rostock, Rostock, Germany
| | - D Imhoff
- Department of Radiation Oncology, University Hospital Frankfurt, Frankfurt, Germany
| | - H Kahl
- Department of Radiation Oncology, Hospital Augsburg, Augsburg, Germany
| | - N D Klass
- Department of Radiation Oncology, University Hospital Bern, Bern, Switzerland
| | - R Krempien
- Department of Radiation Oncology, Helios Klinikum Berlin Buch, Berlin, Germany
| | - V Lewitzki
- Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - F Lohaus
- Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Ostheimer
- Department of Radiation Oncology, University Hospital Halle, Halle, Germany
| | - A Papachristofilou
- Department of Radiation Oncology, University Hospital Hamburg, Hamburg, Germany
| | - C Petersen
- Department of Radiation Oncology, University Hospital Basel, Basel, Switzerland
| | - J Rieber
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | | | - E Schrade
- Department of Radiation Oncology, Hospital Heidenheim, Heidenheim, Germany
| | - R Semrau
- Department of Radiation Oncology, University Hospital of Cologne, Cologne, Germany
| | - S Wachter
- Department of Radiation Oncology, Klinikum Passau, Passau, Germany
| | - A Wittig
- Department of Radiation Oncology, University Hospital Jena, Jena, Germany.,Department of Radiotherapy and Radiation Oncology, Philipps-University Marburg, University Hospital Giessen and Marburg, Marburg, Germany
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - N Andratschke
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
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Klement R, Hoerner-Rieber J, Adebahr S, Andratschke N, Blanck O, Boda-Heggemann J, Duma M, Eble M, Eich H, Flentje M, Gerum S, Hass P, Henkenberens C, Hildebrandt G, Imhoff D, Kahl K, Klass N, Krempien R, Lohaus F, Petersen C, Schrade E, Wendt T, Wittig A, Guckenberger M. Stereotactic body radiotherapy (SBRT) for multiple pulmonary oligometastases: Analysis of number and timing of repeat SBRT as impact factors on treatment safety and efficacy. Radiother Oncol 2018; 127:246-252. [DOI: 10.1016/j.radonc.2018.02.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/14/2018] [Accepted: 02/15/2018] [Indexed: 12/25/2022]
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18
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Leger S, Zwanenburg A, Pilz K, Lohaus F, Linge A, Zöphel K, Kotzerke J, Schreiber A, Tinhofer I, Budach V, Sak A, Stuschke M, Balermpas P, Rödel C, Ganswindt U, Belka C, Pigorsch S, Combs S, Mönnich D, Zips D, Krause M, Baumann M, Richter C, Troost E, Löck S. OC-0508: Identification of tumour sub-volumes for improved radiomic risk modelling in locally advanced HNSCC. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30818-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Hörner-Rieber J, Abbasi-Senger N, Blanck O, Boda-Heggemann J, Duma M, Eble M, Eich H, Flentje M, Gerum S, Haas P, Henkenberens C, Imhoff D, Kahl H, Klass N, Krempien R, Lohaus F, Petersen C, Sackerer I, Schrade E, Uhlmann L, Wittig A, Guckenberger M. PV-0043: Histology as predictor for outcome following SBRT in NSCLC patients with lung oligo-metastases. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30353-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mueller-von der Gruen J, Rödel F, Fokas E, Tinhofer I, Budach V, Krause M, Linge A, Lohaus F, Sak A, Stuschke M, Grosu A, Gkika E, Abdollahi A, Debus J, Ganswindt U, Belka C, Stangl S, Pigorsch S, Multhoff G, Combs S, Welz S, Zips D, Baumann M, Rödel C, Balermpas P. OC-0324: Immune contexture in SCCHN and outcome after chemoradiotherapy in an uni- and multicentric cohort. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30634-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Guckenberger M, Klement R, Rieber J, Adebahr S, Andratschke N, Blanck O, Boda-Heggemann J, Duma M, Eble M, Eich H, Flentje M, Gerum S, Haas P, Henkenberens C, Hildebrandt G, Imhoff D, Kahl H, Klass N, Krempien R, Lohaus F, Petersen C, Schrade E, Wendt T, Wittig A. PV-0044: Repeat sbrt for pulmonary oligo-metastases. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30354-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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22
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Gkika E, Tanadini-Lang S, Kirste S, Holzner PA, Neeff HP, Rischke HC, Reese T, Lohaus F, Duma MN, Dieckmann K, Semrau R, Stockinger M, Imhoff D, Kremers N, Häfner MF, Andratschke N, Nestle U, Grosu AL, Guckenberger M, Brunner TB. Interobserver variability in target volume delineation of hepatocellular carcinoma. Strahlenther Onkol 2017; 193:823-830. [DOI: 10.1007/s00066-017-1177-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 06/22/2017] [Indexed: 12/22/2022]
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Gkika E, Tandini-Lang S, Kirste S, Holzner P, Neeff H, Rischke H, Reese T, Lohaus F, Duma M, Dieckmann K, Semrau R, Stockinger M, Imhoff D, Kremers N, Häfner M, Andratschke N, Nestle U, Grosu A, Guckenberger M, Brunner T. EP-1253: Interobserver variability in the target delineation of hepatocellular carcinoma. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31688-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tanadini-Lang S, Rieber J, Filippi AR, Fode MM, Streblow J, Adebahr S, Andratschke N, Blanck O, Boda-Heggemann J, Duma M, Eble MJ, Ernst I, Flentje M, Gerum S, Hass P, Henkenberens C, Hildebrandt G, Imhoff D, Kahl H, Klass ND, Krempien R, Lohaus F, Petersen C, Schrade E, Wendt TG, Wittig A, Høyer M, Ricardi U, Sterzing F, Guckenberger M. Nomogram based overall survival prediction in stereotactic body radiotherapy for oligo-metastatic lung disease. Radiother Oncol 2017; 123:182-188. [PMID: 28169042 DOI: 10.1016/j.radonc.2017.01.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 12/28/2016] [Accepted: 01/03/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Radical local treatment of pulmonary metastases is practiced with increasing frequency due to acknowledgment and better understanding of oligo-metastatic disease. This study aimed to develop a nomogram predicting overall survival (OS) after stereotactic body radiotherapy (SBRT) for pulmonary metastases. PATIENTS AND METHODS A multi-institutional database of 670 patients treated with SBRT for pulmonary metastases was used as training cohort. Cox regression analysis with bidirectional variable elimination was performed to identify factors to be included into the nomogram model to predict 2-year OS. The calibration rate of the nomogram was assessed by plotting the actual Kaplan-Meier 2-year OS against the nomogram predicted survival. The nomogram was externally validated using two separate monocentric databases of 145 and 92 patients treated with SBRT for pulmonary metastases. RESULTS The median follow up of the trainings cohort was 14.3months, the 2-year and 5-year OS was 52.6% and 23.7%, respectively. Karnofsky performance index, type of the primary tumor, control of the primary tumor, maximum diameter of the largest treated metastasis and number of metastases (1 versus >1) were significant prognostic factors in the Cox model (all p<0.05). The calculated concordance-index for the nomogram was 0.73 (concordance indexes of all prognostic factors between 0.54 and 0.6). Based on the nomogram the training cohort was divided into 4 groups and 2-year OS ranged between 24.2% and 76.1% (predicted OS between 30.2% and 78.4%). The nomogram discriminated between risk groups in the two validation cohorts (concordance index 0.68 and 0.67). CONCLUSIONS A nomogram for prediction of OS after SBRT for pulmonary metastases was generated and externally validated. This tool might be helpful for interdisciplinary discussion and evaluation of local and systemic treatment options in the oligo-metastatic setting. KEY MESSAGE A nomogram for prediction of overall survival after stereotactic body radiotherapy (SBRT) for pulmonary metastases was developed and externally validated. This tool might be helpful for interdisciplinary discussion and evaluation of local and systemic treatment options in the oligo-metastatic setting.
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Affiliation(s)
- S Tanadini-Lang
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland
| | - J Rieber
- Department of Radiation Oncology, University Hospital Heidelberg, Germany; Heidelberg Institute of Radiation Oncology, Germany
| | - A R Filippi
- Department of Oncology, University of Torino, Torino, Italy
| | - M M Fode
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - J Streblow
- Department of Radiation Oncology, University Hospital Heidelberg, Germany; Heidelberg Institute of Radiation Oncology, Germany
| | - S Adebahr
- Department of Radiation Oncology, University Hospital Freiburg, Germany
| | - N Andratschke
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland; Department of Radiation Oncology, University of Rostock, Germany
| | - O Blanck
- Department of Radiation Oncology, UKSH Universitätsklinikum Schleswig Holstein, Kiel, Germany
| | - J Boda-Heggemann
- Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Germany
| | - M Duma
- Department of Radiation Oncology, Technical University Munich, Germany
| | - M J Eble
- Department of Radiation Oncology, University Hospital Aachen, Germany
| | - I Ernst
- Department of Radiation Oncology, University Hospital Münster, Germany
| | - M Flentje
- Department of Radiation Oncology, University Hospital Wuerzburg, Germany
| | - S Gerum
- Department of Radiation Oncology, 11 Ludwig Maximilians University Munich, Germany
| | - P Hass
- Department of Radiation Oncology, University Hospital Magdeburg, Germany
| | - C Henkenberens
- Department of Radiotherapy and Special Oncology, Medical School Hannover, Germany
| | - G Hildebrandt
- Department of Radiation Oncology, University of Rostock, Germany
| | - D Imhoff
- Department of Radiation Oncology, University Hospital Frankfurt, Germany
| | - H Kahl
- Department of Radiation Oncology, Hospital Augsburg, Germany
| | - N D Klass
- Department of Radiation Oncology, Bern University Hospital, Bern, Switzerland
| | - R Krempien
- Department of Radiation Oncology, Helios Klinikum Berlin Buch, Germany
| | - F Lohaus
- Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; German Cancer Research Center (DKFZ), Heidelberg Germany and German Cancer Consortium (DKTK), Dresden, Germany; OncoRay - National Center for Radiation Research in Oncology (NCRO), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - C Petersen
- Department of Radiation Oncology, University Hospital Hamburg, Germany
| | - E Schrade
- Department of Radiation Oncology, Hospital Heidenheim, Germany
| | - T G Wendt
- Department of Radiation Oncology, University Hospital Jena, Germany
| | - A Wittig
- Department of Radiotherapy and Radiation Oncology, Philipps-University Marburg, University Hospital Giessen and Marburg, Germany
| | - M Høyer
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - U Ricardi
- Department of Oncology, University of Torino, Torino, Italy
| | - F Sterzing
- Department of Radiation Oncology, University Hospital Heidelberg, Germany; Heidelberg Institute of Radiation Oncology, Germany; German Cancer Research Center, Clinical Cooperation Unit Radiation Oncology, Heidelberg, Germany
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.
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Tinhofer I, Budach V, Saki M, Konschak R, Niehr F, Jöhrens K, Weichert W, Linge A, Lohaus F, Krause M, Neumann K, Endris V, Sak A, Stuschke M, Balermpas P, Rödel C, Avlar M, Grosu A, Abdollahi A, Debus J, Belka C, Pigorsch S, Combs S, Mönnich D, Zips D, Baumann M. Targeted next-generation sequencing of locally advanced squamous cell carcinomas of the head and neck reveals druggable targets for improving adjuvant chemoradiation. Eur J Cancer 2016; 57:78-86. [DOI: 10.1016/j.ejca.2016.01.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/05/2016] [Accepted: 01/09/2016] [Indexed: 12/22/2022]
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26
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Sterzing F, Streblow J, Scherer K, Adebahr S, Adratschke N, Boda-Heggemann J, Blanck O, Duma M, Ernst I, Gademann G, Ganswindt U, Henkenberens C, Imhoff D, Kahl H, Lohaus F, Lubinski-de Lange G, Maertin A, Petersen C, Wittig A, Guckenberger M. SBRT for Lung Metastases: A Pooled Analysis of 651 Patients and 868 Lesions of the German Working Group Stereotactic Radiotherapy. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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