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1. Influence of brain metastases on the classification, treatment, and outcome of patients with extracranial oligometastasis: a single-center cross-sectional analysis

Author

Christ, Sebastian M., Thiel, Gabriel W., Heesen, Philip, Roohani, Siyer, Mayinger, Michael, Willmann, Jonas, Ahmadsei, Maiwand, Muehlematter, Urs J., Maurer, Alexander, Buchner, Josef A., Peeken, Jan C., Rahman, Rifaquat, Aizer, Ayal, Rhun, Emilie Le, Andratschke, Nicolaus, Weller, Michael, Huellner, Martin, and Guckenberger, Matthias

Published
2024
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2. Clinical management of oligometastatic cancer: Applying multidisciplinary tumor board recommendations in practice

Author

Christ, Sebastian M., Breitenstein, Minsu, Heesen, Philip, Turner, Brandon, Muehlematter, Urs J., Pohl, Kaspar, Willmann, Jonas, Maurer, Alexander, Nagpal, Sukhdeep K., Ahmadsei, Maiwand, Badra Vlaskou, Eugenia, Looman, Esmée L., Heusel, Astrid E., Mayinger, Michael, Balermpas, Panagiotis, Wicki, Andreas, Andratschke, Nicolaus, Balboni, Tracy, Anh Huynh, Mai, Huellner, Martin, and Guckenberger, Matthias

Published
2024
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3. Dose escalation for stereotactic arrhythmia radioablation of recurrent ventricular tachyarrhythmia - a phase II clinical trial

Author

Kovacs, Boldizsar, Mayinger, Michael, Ehrbar, Stefanie, Fesslmeier, Debra, Ahmadsei, Maiwand, Sazgary, Lorraine, Manka, Robert, Alkadhi, Hatem, Ruschitzka, Frank, Duru, Firat, Papachristofilou, Alexandros, Sticherling, Christian, Blamek, Slawomir, Gołba, Krzysztof S., Guckenberger, Matthias, Saguner, Ardan M., and Andratschke, Nicolaus

Published
2023
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7. Health-related quality of life in men with oligometastatic prostate cancer following metastases-directed stereotactic body radiotherapy: Real-world data from the E2-RADIatE OligoCare cohort

Author

Bultijnck, Renée, Van Hemelrijck, Mieke, Fonteyne, Valérie, Livi, Lorenzo, Jereczek-Fossa, Barbara Alicja, Hemmatazad, Hossein, Mayinger, Michael, Peulen, Heike, Verbeke, Luc, Ramella, Sara, Castro, Pablo, Tsoutsou, Pelagia, Stellamans, Karin, Shaukat, Adnan, Orazem, Miha, Jeene, Paul, Braam, Pètra, Verkooijen, Helena, Simek, Inga-Malin, Alongi, Filippo, Clementel, Enrico, Fortpied, Catherine, Machingura, Abigirl, Boakye Oppong, Felix, Guckenberger, Matthias, and Ost, Piet

Published
2024
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9. Refining critical structure contouring in STereotactic Arrhythmia Radioablation (STAR): Benchmark results and consensus guidelines from the STOPSTORM.eu consortium

Author

Balgobind, Brian V., Visser, Jorrit, Grehn, Melanie, Marquard Knap, Marianne, de Ruysscher, Dirk, Levis, Mario, Alcantara, Pino, Boda-Heggemann, Judit, Both, Marcus, Cozzi, Salvatore, Cvek, Jakub, Dieleman, Edith M.T., Elicin, Olgun, Giaj-Levra, Niccolò, Jumeau, Raphaël, Krug, David, Algara López, Manuel, Mayinger, Michael, Mehrhof, Felix, Miszczyk, Marcin, Pérez-Calatayud, Maria José, van der Pol, Luuk H.G., van der Toorn, Peter-Paul, Vitolo, Viviana, Postema, Pieter G., Pruvot, Etienne, Verhoeff, Joost C., and Blanck, Oliver

Published
2023
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12. Identifying core MRI sequences for reliable automatic brain metastasis segmentation

Author

Buchner, Josef A, Peeken, Jan C, Etzel, Lucas, Ezhov, Ivan, Mayinger, Michael, Christ, Sebastian M, Brunner, Thomas B, Wittig, Andrea, Menze, Bjoern H, Zimmer, Claus, Meyer, Bernhard, Guckenberger, Matthias, Andratschke, Nicolaus, El Shafie, Rami A, Debus, Jürgen, Rogers, Susanne, Riesterer, Oliver, Schulze, Katrin, Feldmann, Horst J, Blanck, Oliver, Zamboglou, Constantinos, Ferentinos, Konstantinos, Bilger, Angelika, Grosu, Anca L, Wolff, Robert, Kirschke, Jan S, Eitz, Kerstin A, Combs, Stephanie E, Bernhardt, Denise, Rueckert, Daniel, Piraud, Marie, Wiestler, Benedikt, and Kofler, Florian

Published
2023
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13. Potential of ChatGPT in facilitating research in radiation oncology?

Author

Guckenberger, Matthias, Andratschke, Nicolaus, Ahmadsei, Maiwand, Christ, Sebastian Matthias, Heusel, Astrid Elisabeth, Kamal, Sandeep, Kroese, Tiuri Ewout, Looman, Esmée Lauren, Reichl, Sabrina, Vlaskou Badra, Eugenia, von der Grün, Jens, Willmann, Jonas, Tanadini-Lang, Stephanie, and Mayinger, Michael

Published
2023
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20. Treatment Planning for Cardiac Radioablation: Multicenter Multiplatform Benchmarking for the RAdiosurgery for VENtricular TAchycardia (RAVENTA) Trial

Author

Kluge, Anne, Ehrbar, Stefanie, Grehn, Melanie, Fleckenstein, Jens, Baus, Wolfgang W., Siebert, Frank-Andre, Schweikard, Achim, Andratschke, Nicolaus, Mayinger, Michael C., Boda-Heggemann, Judit, Buergy, Daniel, Celik, Eren, Krug, David, Kovacs, Boldizsar, Saguner, Ardan M., Rudic, Boris, Bergengruen, Paula, Boldt, Leif-Hendrik, Stauber, Annina, Zaman, Adrian, Bonnemeier, Hendrik, Dunst, Jürgen, Budach, Volker, Blanck, Oliver, and Mehrhof, Felix

Published
2022
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23. Radiomics-based prediction of local control in patients with brain metastases following postoperative stereotactic radiotherapy.

Author

Buchner, Josef A, Kofler, Florian, Mayinger, Michael, Christ, Sebastian M, Brunner, Thomas B, Wittig, Andrea, Menze, Bjoern, Zimmer, Claus, Meyer, Bernhard, Guckenberger, Matthias, Andratschke, Nicolaus, Shafie, Rami A El, Debus, Jürgen, Rogers, Susanne, Riesterer, Oliver, Schulze, Katrin, Feldmann, Horst J, Blanck, Oliver, Zamboglou, Constantinos, and Ferentinos, Konstantinos

Published
2024
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25. Interdisciplinary Clinical Target Volume Generation for Cardiac Radioablation: Multicenter Benchmarking for the RAdiosurgery for VENtricular TAchycardia (RAVENTA) Trial

Author

Boda-Heggemann, Judit, Blanck, Oliver, Mehrhof, Felix, Ernst, Floris, Buergy, Daniel, Fleckenstein, Jens, Tülümen, Erol, Krug, David, Siebert, Frank-Andre, Zaman, Adrian, Kluge, Anne K., Parwani, Abdul Shokor, Andratschke, Nicolaus, Mayinger, Michael C., Ehrbar, Stefanie, Saguner, Ardan M., Celik, Eren, Baus, Wolfgang W., Stauber, Annina, Vogel, Lena, Schweikard, Achim, Budach, Volker, Dunst, Jürgen, Boldt, Leif-Hendrik, Bonnemeier, Hendrik, and Rudic, Boris

Published
2021
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26. Health-related quality of life in men with oligometastatic prostate cancer following metastases-directed stereotactic body radiotherapy: Real-world data from the E2-RADIatE OligoCare cohort

Author

Trialbureau Beeld, Cancer, Bultijnck, Renée, Van Hemelrijck, Mieke, Fonteyne, Valérie, Livi, Lorenzo, Jereczek-Fossa, Barbara Alicja, Hemmatazad, Hossein, Mayinger, Michael, Peulen, Heike, Verbeke, Luc, Ramella, Sara, Castro, Pablo, Tsoutsou, Pelagia, Stellamans, Karin, Shaukat, Adnan, Orazem, Miha, Jeene, Paul, Braam, Pètra, Verkooijen, Helena, Simek, Inga Malin, Alongi, Filippo, Clementel, Enrico, Fortpied, Catherine, Machingura, Abigirl, Boakye Oppong, Felix, Guckenberger, Matthias, Ost, Piet, Trialbureau Beeld, Cancer, Bultijnck, Renée, Van Hemelrijck, Mieke, Fonteyne, Valérie, Livi, Lorenzo, Jereczek-Fossa, Barbara Alicja, Hemmatazad, Hossein, Mayinger, Michael, Peulen, Heike, Verbeke, Luc, Ramella, Sara, Castro, Pablo, Tsoutsou, Pelagia, Stellamans, Karin, Shaukat, Adnan, Orazem, Miha, Jeene, Paul, Braam, Pètra, Verkooijen, Helena, Simek, Inga Malin, Alongi, Filippo, Clementel, Enrico, Fortpied, Catherine, Machingura, Abigirl, Boakye Oppong, Felix, Guckenberger, Matthias, and Ost, Piet

Published
2024

27. Stereotactic body radiotherapy for oligoprogression with or without switch of systemic therapy

Author

Willmann, Jonas; https://orcid.org/0000-0002-2531-3551, Vlaskou Badra, Eugenia, Adilovic, Selma, Ahmadsei, Maiwand; https://orcid.org/0000-0002-0646-2762, Christ, Sebastian M; https://orcid.org/0000-0001-5330-3820, Tanadini-Lang, Stephanie; https://orcid.org/0000-0002-4387-1522, Mayinger, Michael; https://orcid.org/0000-0003-4433-2552, Guckenberger, Matthias; https://orcid.org/0000-0002-7146-9071, Andratschke, Nicolaus, Willmann, Jonas; https://orcid.org/0000-0002-2531-3551, Vlaskou Badra, Eugenia, Adilovic, Selma, Ahmadsei, Maiwand; https://orcid.org/0000-0002-0646-2762, Christ, Sebastian M; https://orcid.org/0000-0001-5330-3820, Tanadini-Lang, Stephanie; https://orcid.org/0000-0002-4387-1522, Mayinger, Michael; https://orcid.org/0000-0003-4433-2552, Guckenberger, Matthias; https://orcid.org/0000-0002-7146-9071, and Andratschke, Nicolaus

Abstract

BACKGROUND Oligoprogression is defined as cancer progression of a limited number of metastases under active systemic therapy. The role of metastasis-directed therapy, using stereotactic body radiotherapy (SBRT), is controversial as is the continuation versus switch of systemic therapy. We report outcomes of oligoprogressive patients after SBRT, and compare those patients that continued or switched their current line of systemic therapy. MATERIAL/METHODS We included patients who developed up to 5 progressive extracranial metastases under systemic therapy for any solid organ malignancy and were treated with SBRT to all lesions at our institution between 01/2014 and 12/2019. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier method, and the interval to the next systemic therapy line determined using cumulative incidence functions. Multivariable Cox regression models were used to analyze the influence of baseline and post-progression variables on OS, PFS and survival with the next systemic therapy after SBRT. RESULTS Among 135 patients with oligoprogressive disease of which the most common primary tumor was lung cancer (n = 46, 34.1 %), 96 continued their current line of systemic therapy after oligoprogression. Among 39 who switched systemic therapy, 28 (71.8 %) paused or discontinued, while 11 (28.2 %) immediately started another systemic treatment. After a median follow-up of 27.2 months, patients that switched and those who continued systemic therapy after oligoprogression had comparable median OS (32.1 vs. 38.2 months, p = 0.47) and PFS (4.3 vs. 3.4 months, p = 0.6). The intervals to the next systemic therapy line were comparable between both cohorts (p = 0.6). An ECOG performance status of 2 and immediately starting a new systemic therapy after oligoprogression were associated with a poorer survival without next systemic therapy, while the de-novo OMD state was associated with better survival without next systemic therapy

Published
2024

29. Association of Skin Microbiome Dynamics With Radiodermatitis in Patients With Breast Cancer

Author

Hülpüsch, Claudia, primary, Neumann, Avidan Uriel, additional, Reiger, Matthias, additional, Fischer, Julius Clemens, additional, de Tomassi, Amedeo, additional, Hammel, Gertrud, additional, Gülzow, Carina, additional, Fleming, Megan, additional, Dapper, Hendrik, additional, Mayinger, Michael, additional, Vogel, Marco, additional, Ertl, Christina, additional, Combs, Stephanie Elisabeth, additional, Traidl-Hoffmann, Claudia, additional, and Borm, Kai Joachim, additional

Published
2024
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30. Radiomics-based prediction of local control in patients with brain metastases following postoperative stereotactic radiotherapy

Author

Buchner, Josef A., primary, Kofler, Florian, additional, Mayinger, Michael, additional, Christ, Sebastian M., additional, Brunner, Thomas B., additional, Wittig, Andrea, additional, Menze, Bjoern, additional, Zimmer, Claus, additional, Meyer, Bernhard, additional, Guckenberger, Matthias, additional, Andratschke, Nicolaus, additional, El Shafie, Rami A., additional, Debus, Jürgen, additional, Rogers, Susanne, additional, Riesterer, Oliver, additional, Schulze, Katrin, additional, Feldmann, Horst J., additional, Blanck, Oliver, additional, Zamboglou, Constantinos, additional, Ferentinos, Konstantinos, additional, Bilger-Zähringer, Angelika, additional, Grosu, Anca L., additional, Wolff, Robert, additional, Piraud, Marie, additional, Eitz, Kerstin A., additional, Combs, Stephanie E., additional, Bernhardt, Denise, additional, Rueckert, Daniel, additional, Wiestler, Benedikt, additional, and Peeken, Jan C., additional

Published
2024
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31. Dosimetric analysis of proximal bronchial tree subsegments to assess the risk of severe toxicity after stereotactic body radiation therapy of ultra-central lung tumors

Author

Ahmadsei, Maiwand, primary, Jegarajah, Vinojaa, additional, Dal Bello, Riccardo, additional, Christ, Sebastian M., additional, Mayinger, Michael M., additional, Sabrina Stark, Luisa, additional, Willmann, Jonas, additional, Vogelius, Ivan R., additional, Balermpas, Panagiotis, additional, Andratschke, Nicolaus, additional, Tanadini-Lang, Stephanie, additional, and Guckenberger, Matthias, additional

Published
2023
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33. Vestibular Schwannoma

Author

Mayinger, Michael, Combs, Stephanie E., Chang, Eric L., editor, Brown, Paul D., editor, Lo, Simon S., editor, Sahgal, Arjun, editor, and Suh, John H., editor

Published
2018
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34. Recurrences of ventricular tachycardia after stereotactic arrhythmia radioablation arise outside the treated volume: analysis of the Swiss cohort

Author

Herrera Siklody, Claudia, primary, Schiappacasse, Luis, additional, Jumeau, Raphaël, additional, Reichlin, Tobias, additional, Saguner, Ardan M, additional, Andratschke, Nicolaus, additional, Elicin, Olgun, additional, Schreiner, Frederic, additional, Kovacs, Boldizsar, additional, Mayinger, Michael, additional, Huber, Adrian, additional, Verhoeff, Joost J C, additional, Pascale, Patrizio, additional, Solana Muñoz, Jorge, additional, Luca, Adrian, additional, Domenichini, Giulia, additional, Moeckli, Raphael, additional, Bourhis, Jean, additional, Ozsahin, Esat M, additional, and Pruvot, Etienne, additional

Published
2023
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38. 533: Deep Learning based prediction of time to post-therapy local failure in brain metastasis patients

Author

Erdur, Ayhan Can, Scholz, Daniel, Buchner, Josef A., Mayinger, Michael, Christ, Sebastian M., Brunner, Thomas B., Wittig, Andrea, Meyer, Bernhard, Guckenberger, Matthias, Andratschke, Nicolaus, Schafie, Rami A El, Debus, Juergen, Rogers, Susanne, Riesterer, Oliver, Schulze, Katrin, Blanck, Oliver, Zamboglou, Constantinos, Wolff, Robert, Grosu, Anca L., Bilger, Angelika, Bernhardt, Denise, Combs, Stephanie E., Rueckert, Daniel, Wiestler, Benedikt, and Peeken, Jan C.

Published
2024
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41. Stereotactic Body Radiotherapy for Lung Oligo-metastases:Systematic Review and International Stereotactic Radiosurgery Society Practice Guidelines

Author

Mayinger, Michael, Kotecha, Rupesh, Sahgal, Arjun, Kim, Mi-Sook, Lo, Simon S., Louie, Alexander V., Scorsetti, Marta, Slotman, Ben, and Guckenberger, Matthias

Abstract

Purpose: A systematic review of treatment characteristics, outcomes, and treatment-related toxicities of stereotactic body radiation therapy (SBRT) for pulmonary oligometastases served as the basis for development of this International Stereotactic Radiosurgery Society (ISRS) practice guideline. Methods: In accordance with PRISMA guidelines, a systematic review was performed of retrospective series with ≥50 patients/lung metastases, prospective trials with ≥25 patients/lung metastases, analyses of specific high-risk situations, and all randomized trials published between 2012 and July 2022 in the MEDLINE or Embase database using the key words “lung oligometastases”, “lung metastases”, “pulmonary metastases”, “pulmonary oligometastases”, “stereotactic body radiation therapy (SBRT)” and “stereotactic ablative body radiotherapy (SBRT)”. Weighted random effects models were used to calculate pooled outcomes estimates. Results: Of the 1884 articles screened, 35 analyses (27 retrospective-, 5 prospective, and 3 randomized trials) reporting on treatment of >3600 patients and >4650 metastases were included. The median local control was 90 % (Range: 57–100 %) at 1 year and 79 % (R: 70–96 %) at 5 years. Acute toxicity ≥3 was reported for 0.5 % and late toxicity ≥3 for 1.8 % of patients. A total of 21 practice recommendations covering the areas of staging & patient selection (n = 10), SBRT treatment (n = 10), and follow-up (n = 1) were developed, with agreements rates of 100 %, except for recommendation 13 (83 %). Conclusion: SBRT represents an effective definitive local treatment modality combining high local control rates with low risk of radiation-induced toxicities.

Published
2023

43. Identifying core MRI sequences for reliable automatic brain metastasis segmentation

Author

Buchner, Josef A, primary, Peeken, Jan C, additional, Etzel, Lucas, additional, Ezhov, Ivan, additional, Mayinger, Michael, additional, Christ, Sebastian M, additional, Brunner, Thomas B, additional, Wittig, Andrea, additional, Menze, Björn, additional, Zimmer, Claus, additional, Meyer, Bernhard, additional, Guckenberger, Matthias, additional, Andratschke, Nicolaus, additional, El Shafie, Rami A, additional, Debus, Jürgen, additional, Rogers, Susanne, additional, Riesterer, Oliver, additional, Schulze, Katrin, additional, Feldmann, Horst J, additional, Blanck, Oliver, additional, Zamboglou, Constantinos, additional, Ferentinos, Konstantinos, additional, Bilger, Angelika, additional, Grosu, Anca L, additional, Wolff, Robert, additional, Kirschke, Jan S, additional, Eitz, Kerstin A, additional, Combs, Stephanie E, additional, Bernhardt, Denise, additional, Rückert, Daniel, additional, Piraud, Marie, additional, Wiestler, Benedikt, additional, and Kofler, Florian, additional

Published
2023
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45. Refining critical structure contouring in STereotactic Arrhythmia Radioablation (STAR): Benchmark results and consensus guidelines from the STOPSTORM.eu consortium

Author

Experimentele klinische fysica, MS Radiotherapie, Brain, Cancer, Circulatory Health, Balgobind, Brian V, Visser, Jorrit, Grehn, Melanie, Marquard Knap, Marianne, de Ruysscher, Dirk, Levis, Mario, Alcantara, Pino, Boda-Heggemann, Judit, Both, Marcus, Cozzi, Salvatore, Cvek, Jakub, Dieleman, Edith M T, Elicin, Olgun, Giaj-Levra, Niccolò, Jumeau, Raphaël, Krug, David, Algara López, Manuel, Mayinger, Michael, Mehrhof, Felix, Miszczyk, Marcin, Pérez-Calatayud, Maria José, van der Pol, Luuk H G, van der Toorn, Peter-Paul, Vitolo, Viviana, Postema, Pieter G, Pruvot, Etienne, Verhoeff, Joost C, Blanck, Oliver, Experimentele klinische fysica, MS Radiotherapie, Brain, Cancer, Circulatory Health, Balgobind, Brian V, Visser, Jorrit, Grehn, Melanie, Marquard Knap, Marianne, de Ruysscher, Dirk, Levis, Mario, Alcantara, Pino, Boda-Heggemann, Judit, Both, Marcus, Cozzi, Salvatore, Cvek, Jakub, Dieleman, Edith M T, Elicin, Olgun, Giaj-Levra, Niccolò, Jumeau, Raphaël, Krug, David, Algara López, Manuel, Mayinger, Michael, Mehrhof, Felix, Miszczyk, Marcin, Pérez-Calatayud, Maria José, van der Pol, Luuk H G, van der Toorn, Peter-Paul, Vitolo, Viviana, Postema, Pieter G, Pruvot, Etienne, Verhoeff, Joost C, and Blanck, Oliver

Published
2023

46. Recurrences of ventricular tachycardia after stereotactic arrhythmia radioablation arise outside the treated volume: analysis of the Swiss cohort

Author

MS Radiotherapie, Brain, Cancer, Circulatory Health, Herrera Siklody, Claudia, Schiappacasse, Luis, Jumeau, Raphaël, Reichlin, Tobias, Saguner, Ardan M, Andratschke, Nicolaus, Elicin, Olgun, Schreiner, Frederic, Kovacs, Boldizsar, Mayinger, Michael, Huber, Adrian, Verhoeff, Joost J C, Pascale, Patrizio, Solana Muñoz, Jorge, Luca, Adrian, Domenichini, Giulia, Moeckli, Raphael, Bourhis, Jean, Ozsahin, Esat M, Pruvot, Etienne, MS Radiotherapie, Brain, Cancer, Circulatory Health, Herrera Siklody, Claudia, Schiappacasse, Luis, Jumeau, Raphaël, Reichlin, Tobias, Saguner, Ardan M, Andratschke, Nicolaus, Elicin, Olgun, Schreiner, Frederic, Kovacs, Boldizsar, Mayinger, Michael, Huber, Adrian, Verhoeff, Joost J C, Pascale, Patrizio, Solana Muñoz, Jorge, Luca, Adrian, Domenichini, Giulia, Moeckli, Raphael, Bourhis, Jean, Ozsahin, Esat M, and Pruvot, Etienne

Published
2023

47. Dosimetric Analysis of Proximal Bronchial Tree Subsegments to Assess The Risk of Severe Toxicity After Stereotactic Body Radiation Therapy of Ultra-central Lung Tumors

Author

Ahmadsei, Maiwand; https://orcid.org/0000-0002-0646-2762, Jegarajah, Vinojaa, Dal Bello, Riccardo; https://orcid.org/0000-0002-8755-377X, Christ, Sebastian M; https://orcid.org/0000-0001-5330-3820, Mayinger, Michael M, Sabrina Stark, Luisa, Willmann, Jonas; https://orcid.org/0000-0002-2531-3551, Vogelius, Ivan R, Balermpas, Panagiotis; https://orcid.org/0000-0001-5261-6446, Andratschke, Nicolaus; https://orcid.org/0000-0003-3647-5916, Tanadini-Lang, Stephanie; https://orcid.org/0000-0002-4387-1522, Guckenberger, Matthias; https://orcid.org/0000-0002-7146-9071, Ahmadsei, Maiwand; https://orcid.org/0000-0002-0646-2762, Jegarajah, Vinojaa, Dal Bello, Riccardo; https://orcid.org/0000-0002-8755-377X, Christ, Sebastian M; https://orcid.org/0000-0001-5330-3820, Mayinger, Michael M, Sabrina Stark, Luisa, Willmann, Jonas; https://orcid.org/0000-0002-2531-3551, Vogelius, Ivan R, Balermpas, Panagiotis; https://orcid.org/0000-0001-5261-6446, Andratschke, Nicolaus; https://orcid.org/0000-0003-3647-5916, Tanadini-Lang, Stephanie; https://orcid.org/0000-0002-4387-1522, and Guckenberger, Matthias; https://orcid.org/0000-0002-7146-9071

Abstract

Background and purpose Stereotactic body radiotherapy (SBRT) of ultra-central lung tumors (UCLT) is associated with an increased risk of severe toxicity. The aim of this study was to perform a detailed dosimetric analysis of the proximal bronchial tree (PBT) anatomical sub-segments to evaluate the safety of risk-adapted SBRT and to evaluate potential differences in radiation tolerance between PBT sub-segments. Material and methods Fifty-seven patients treated with SBRT for UCLT between 2014 and 2021 were included. UCLT were defined as tumor abutting or overlapping with the trachea, PBT, or esophagus. This study analyzed overall survival, local control, progression-free survival, and grade ≥3 toxicity events. Bayesian inference was used to build a dose-response model with upper limits for toxicity. Results Twenty-seven (47.4%) of the irradiated lesions were primary or locoregionally recurrent NSCLC and 30 (52.6%) oligometastases. All patients were treated with risk-adapted SBRT of median 45.0 Gy (range: 30.0-60.0 Gy) in 8 or 10 fractions. Grade ≥3 radiation pneumonitis was observed in two patients (3.5%), while no bronchial stenosis, hemorrhage or fistula were observed. The dose-response model predicted a grade ≥3 toxicity (stenosis, hemorrhage or fistula) limited to 4.9% (0 - 11.4%) when delivering EQD2$\_$3 = 100 Gy to any location of the PBT (D0.2cc). Detailed dosimetric analysis of PBT substructures showed no variation in the dose-response model between the anatomical PBT sub-segments. Conclusion Risk-adapted SBRT regimens delivered in 8 or 10 fractions for ultra-central lung tumors resulted in high rates of local tumor control with low toxicity rates, without differences in radiation tolerance between the anatomical PBT sub-segments.

Published
2023

48. Refining Critical Structure Contouring in STereotactic Arrhythmia Radioablation (STAR): Benchmark Results and Consensus Guidelines from the STOPSTORM.eu Consortium

Author

Balgobind, Brian V, Visser, Jorrit, Grehn, Melanie, Marquard Knap, Marianne, de Ruysscher, Dirk, Levis, Mario, Alcantara, Pino, Boda-Heggemann, Judit, Both, Marcus, Cozzi, Salvatore, Cvek, Jakub, Dieleman, Edith M T, Elicin, Olgun, Giaj-Levra, Niccolò, Jumeau, Raphaël, Krug, David, Algara López, Manuel; https://orcid.org/0000-0002-0500-9202, Mayinger, Michael, Mehrhof, Felix, Miszczyk, Marcin, Pérez-Calatayud, Maria José, van der Pol, Luuk H G, van der Toorn, Peter-Paul, Vitolo, Viviana, Postema, Pieter G, Pruvot, Etienne, Verhoeff, Joost C, Blanck, Oliver, Balgobind, Brian V, Visser, Jorrit, Grehn, Melanie, Marquard Knap, Marianne, de Ruysscher, Dirk, Levis, Mario, Alcantara, Pino, Boda-Heggemann, Judit, Both, Marcus, Cozzi, Salvatore, Cvek, Jakub, Dieleman, Edith M T, Elicin, Olgun, Giaj-Levra, Niccolò, Jumeau, Raphaël, Krug, David, Algara López, Manuel; https://orcid.org/0000-0002-0500-9202, Mayinger, Michael, Mehrhof, Felix, Miszczyk, Marcin, Pérez-Calatayud, Maria José, van der Pol, Luuk H G, van der Toorn, Peter-Paul, Vitolo, Viviana, Postema, Pieter G, Pruvot, Etienne, Verhoeff, Joost C, and Blanck, Oliver

Abstract

BACKGROUND AND PURPOSE In patients with recurrent ventricular tachycardia (VT), STereotactic Arrhythmia Radioablation (STAR) shows promising results. The STOPSTORM consortium was established to investigate and harmonise STAR treatment in Europe. The primary goals of this benchmark study were to standardise contouring of organs at risk (OAR) for STAR, including detailed substructures of the heart, and accredit each participating centre. MATERIALS AND METHODS Centres within the STOPSTORM consortium were asked to delineate 31 OAR in three STAR cases. Delineation was reviewed by the consortium expert panel and after a dedicated workshop feedback and accreditation was provided to all participants. Further quantitative analysis was performed by calculating DICE similarity coefficients (DSC), median distance to agreement (MDA), and 95th percentile distance to agreement (HD95). RESULTS Twenty centres participated in this study. Based on DSC, MDA and HD95, the delineations of well-known OAR in radiotherapy were similar, such as lungs (median DSC=0.96, median MDA=0.1mm and median HD95=1.1mm) and aorta (median DSC=0.90, median MDA=0.1mm and median HD95=1.5mm). Some centres did not include the gastro-oesophageal junction, leading to differences in stomach and oesophagus delineations. For cardiac substructures, such as chambers (median DSC=0.83, median MDA=0.2mm and median HD95=0.5mm), valves (median DSC=0.16, median MDA=4.6mm and median HD95=16.0mm), coronary arteries (median DSC=0.4, median MDA=0.7mm and median HD95=8.3mm) and the sinoatrial and atrioventricular nodes (median DSC=0.29, median MDA=4.4mm and median HD95=11.4mm), deviations between centres occurred more frequently. After the dedicated workshop all centres were accredited and contouring consensus guidelines for STAR were established. CONCLUSION This STOPSTORM multi-centre critical structure contouring benchmark study showed high agreement for standard radiotherapy OAR. However, for cardiac substructures larger dis

Published
2023

49. External Validation of Three Prognostic Scores for Brain Metastasis Velocity in Patients Treated with Intracranial Stereotactic Radiotherapy

Author

Christ, Sebastian M, Borsky, Kim, Kraft, Johannes, Frei, Simon, Willmann, Jonas, Ahmadsei, Maiwand, Kirchner, Corinna, Sabrina Stark Schneebeli, Luisa, Camilli, Federico, Tanadini-Lang, Stephanie, Rahman, Rifaquat, Aizer, Ayal A, Guckenberger, Matthias, Andratschke, Nicolaus, Mayinger, Michael, Christ, Sebastian M, Borsky, Kim, Kraft, Johannes, Frei, Simon, Willmann, Jonas, Ahmadsei, Maiwand, Kirchner, Corinna, Sabrina Stark Schneebeli, Luisa, Camilli, Federico, Tanadini-Lang, Stephanie, Rahman, Rifaquat, Aizer, Ayal A, Guckenberger, Matthias, Andratschke, Nicolaus, and Mayinger, Michael

Abstract

BACKGROUND AND INTRODUCTION Brain metastasis velocity (BMV) has been proposed as a prognostic factor for overall survival (OS) in patients with brain metastases (BMs). In this study, we conducted an external validation and comparative assessment of the performance of all three BMV scores. MATERIALS AND METHODS Patients treated with intracranial stereotactic radiotherapy (SRT) for BM at a single center between 2014 and 2018 were identified. Where possible, all three BMV scores were calculated. Log-rank tests and linear, logistic and Cox regression analysis were used for validation and predictor identification of OS. RESULTS For 333 of 384 brain metastasis patients, at least one BMV score could be calculated. In a sub-group of 187 patients, "classic" BMV was validated as categorical (p<0.0001) and continuous variable (HR 1.02; 95% CI 1.02-1.03; p<0.0001). In a sub-group of 284 patients, "initial" BMV was validated as categorical variable (high-risk vs. low-risk; p<0.01), but not as continuous variable (HR 1.02; 95% CI 0.99-1.04; p=0.224). "Volume-based" BMV could not be validated in a sub-group of 104 patients. On multivariable Cox regression analysis, iBMV (HR 1.85; 95% CI 1.01-3.38; p<0.05) and cBMV (HR 2.32; 95% CI 1.15 4.68; p<0.05) were predictors for OS for intermediate-risk patients after first SRT and first DBFs, respectively. cBMV proved to be the dominant predictor for OS for high-risk patients (HR 2.99; 95% CI 1.30-6.91; p<0.05). CONCLUSION This study externally validated cBMV and iBMV as prognostic scores for OS in patients treated with SRT for BMs whereas validation of vBMV was not achieved.

Published
2023

50. Dose escalation for stereotactic arrhythmia radioablation of recurrent ventricular tachyarrhythmia - a phase II clinical trial

Author

Kovacs, Boldizsar; https://orcid.org/0000-0002-7972-5199, Mayinger, Michael; https://orcid.org/0000-0003-4433-2552, Ehrbar, Stefanie; https://orcid.org/0000-0002-2471-1259, Fesslmeier, Debra, Ahmadsei, Maiwand, Sazgary, Lorraine, Manka, Robert; https://orcid.org/0000-0002-3383-4998, Alkadhi, Hatem; https://orcid.org/0000-0002-2581-2166, Ruschitzka, Frank; https://orcid.org/0000-0001-5972-0596, Duru, Firat; https://orcid.org/0000-0002-4748-0158, Papachristofilou, Alexandros, Sticherling, Christian; https://orcid.org/0000-0001-8428-7050, Blamek, Slawomir, Gołba, Krzysztof S, Guckenberger, Matthias; https://orcid.org/0000-0002-7146-9071, Saguner, Ardan M; https://orcid.org/0000-0003-1896-0803, Andratschke, Nicolaus; https://orcid.org/0000-0003-3647-5916, Kovacs, Boldizsar; https://orcid.org/0000-0002-7972-5199, Mayinger, Michael; https://orcid.org/0000-0003-4433-2552, Ehrbar, Stefanie; https://orcid.org/0000-0002-2471-1259, Fesslmeier, Debra, Ahmadsei, Maiwand, Sazgary, Lorraine, Manka, Robert; https://orcid.org/0000-0002-3383-4998, Alkadhi, Hatem; https://orcid.org/0000-0002-2581-2166, Ruschitzka, Frank; https://orcid.org/0000-0001-5972-0596, Duru, Firat; https://orcid.org/0000-0002-4748-0158, Papachristofilou, Alexandros, Sticherling, Christian; https://orcid.org/0000-0001-8428-7050, Blamek, Slawomir, Gołba, Krzysztof S, Guckenberger, Matthias; https://orcid.org/0000-0002-7146-9071, Saguner, Ardan M; https://orcid.org/0000-0003-1896-0803, and Andratschke, Nicolaus; https://orcid.org/0000-0003-3647-5916

Abstract

BACKGROUND: Stereotactic arrhythmia radioablation (STAR) is delivered with a planning target volume (PTV) prescription dose of 25 Gy, mostly to the surrounding 75-85% isodose line. This means that the average and maximum dose received by the target is less than 35 Gy, which is the minimum threshold required to create a homogenous transmural fibrosis. Similar to catheter ablation, the primary objective of STAR should be transmural fibrosis to prevent heterogenous intracardiac conduction velocities and the occurrence of sustained ventricular arrhythmias (sVA) caused by reentry. We hypothesize that the current dose prescription used in STAR is inadequate for the long-term prevention of sVA and that a significant increase in dose is necessary to induce transmural scar formation. OBJECTIVE: A single arm, multi-center, phase II, dose escalation prospective clinical trial employing the i3 + 3 design is being conducted to examine the safety of a radiation dose-escalation strategy aimed at inducing transmural scar formation. The ultimate objective of this trial is to decrease the likelihood of sVA recurrence in patients at risk. METHODS: Patients with ischemic or non-ischemic cardiomyopathy and recurrent sVA, with an ICD and history of ≥ 1 catheter ablation for sVA will be included. This is a prospective, multicenter, one-arm, dose-escalation trial utilizing the i3 + 3 design, a modified 3 + 3 specifically created to overcome limitations in traditional dose-finding studies. A total of 15 patients will be recruited. The trial aims to escalate the ITV dose from 27.0 Gy to an ITV prescription dose-equivalent level of maximum 35.1 Gy by keeping the PTV prescription dose constant at 25 Gy while increasing the dose to the target (i.e. the VT substrate without PTV margin) by step-wise reduction of the prescribing isodose line (85% down to 65%). The primary outcome of this trial is safety measured by registered radiation associated adverse events (AE) up to 90 days after study inter

Published
2023

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