Strahlentherapie und Onkologie最新文献

Background and purpose: Radiation oncology (RO) is a key component of cancer care and should be adequately represented in undergraduate medical education. In light of medical training reforms in German medical education and rising expectations for competency-based, practice-oriented learning, this nationwide survey explored medical students' perspectives on RO teaching and its future development.

Materials and methods: A cross-sectional online survey was conducted from 2023 to 2025 across all 38 German medical faculties. Developed by the Working Group on Teaching of the German Society for Radiation Oncology (DEGRO), the 49-item questionnaire addressed curriculum structure, teaching quality, preferred formats, and interest in RO.

Results: Among 1112 participants, 739 completed the survey. Although 96% viewed RO as being essential to cancer care, 62% felt it was underrepresented in the curriculum. Students called for more interdisciplinary and patient-centered teaching and showed high interest in digital and hybrid learning formats. Notably, 60.5% favored interdisciplinary oncology formats including RO, and nearly half expressed interest in elective RO courses.

Conclusion: Despite its recognized importance, RO remains inconsistently represented in medical education. Embedding RO in interdisciplinary oncology modules and expanding digital, longitudinal, and flexible teaching formats could enhance its visibility and relevance. Given students' strong interest in more in-depth exposure, optional and elective formats should be further developed to meet modern educational expectations.

Purpose: This study developed an efficient methodology for in-house 3D-printed vaginal cylinders for gynecologic tumor treatment by evaluating their radiation attenuation, geometric accuracy, and efficacy. Ultimately, we aim to establish a simple, cost-effective approach that facilitates broad clinical adoption.

Methods: Patient-specific vaginal cylinders were designed based on anatomical contours from the treatment planning system (TPS) using CAD software. The process was optimized to minimize manpower and time costs. Radiation attenuation of the 3D printer material was compared with that of water using the Monte Carlo method. Geometric accuracy was automatically analyzed via an in-house MATLAB program. Efficacy was assessed in cases of postoperative vaginal stump recurrence and vaginal cancer with paravaginal invasion.

Results: The tumor shape, delineated by TPS, was imported into CAD software, and the catheter pathway model, designed via subtraction processing, was placed at the optimal position and angle. The design process took approximately 15 min, and the entire workflow was completed within a week, demonstrating its practicality for clinical use. The radiation attenuation error was < 3% compared with water, and the geometric accuracy error was < 0.2 mm. The patient-specific vaginal cylinder provided a favorable dose distribution and was effective in complex cases.

Conclusion: A feasible workflow was established, allowing in-house design and manufacturing with reduced manpower and time costs. With no material or processing issues, this approach is safe, practical, and promising for widespread adoption in personalized brachytherapy.

Purpose: The precise mechanisms underlying radiation-induced cataractogenesis remain incompletely understood. Increased oxidative stress is known to play a central role in cataract pathogenesis. The vitreous humor contributes to maintaining the hypoxic environment of the lens by regulating oxygen pressure and containing antioxidants. This study aims to explore the effect of radiation-induced changes in the vitreous humor on lens health, with a particular focus on its cataractogenic potential.

Methods: In this experimental study, 12 New Zealand rabbits were utilized. A single 20-Gy dose of radiation was administered to the left eye's vitreous humor with a lens-sparing technique, while the right eye served as a control. Monthly ophthalmological evaluations were conducted over a 3-month period. At the end of the follow-up, orbital magnetic resonance imaging (MRI) was performed. Vitreous humor samples were analyzed using spectrophotometric methods to determine total oxidant and antioxidant levels.

Results: Cataract formation was observed in two of the eight irradiated eyes (25%). The MRI analysis revealed a significant reduction in signal intensity within the left eye's aqueous humor in non-contrast sequences (p = 0.03), while an increase in signal intensity was observed in late post-contrast sequences (p = 0.04). Spectrophotometric analysis indicated that total oxidant levels (p = 0.04) and the oxidative stress index (p = 0.04) were significantly lower in the treatment group.

Conclusion: These findings suggest that radiation-induced changes in the vitreous humor and posterior ocular structures may influence the anterior chamber, contributing to the development of radiation-induced cataracts.

Background: Total skin electron irradiation (TSEI) is a specialized radiotherapy technique used to treat cutaneous T‑cell lymphoma, including mycosis fungoides and Sézary syndrome. Despite its clinical benefits, TSEI is rarely implemented in clinical practice due to significant technical and organizational challenges. This study explores a structured approach to integrating TSEI into clinical routines by applying a comprehensive change management framework in a German radiotherapy department.

Methods: The implementation process was based on Kotter's eight-step change management model and carried out from 2022 to 2024 by a multidisciplinary team. Key steps included creating a sense of urgency, forming a guiding coalition, developing and communicating a clear vision, and pilot testing to generate short-term successes. A dynamic stakeholder analysis was conducted to continuously identify and manage factors that could promote or hinder the change.

Results: The structured approach facilitated integration of TSEI into routine practice. The project enabled comprehensive staff training, adaptation of technical workflows, and development of necessary protocols and equipment. Key milestones were achieved, including initial patient treatments and positive staff feedback, demonstrating the method's feasibility and acceptance. The stakeholder analysis was instrumental in reducing apprehensions and maintaining alignment among team members.

Conclusion: This study demonstrates that a structured change management approach is effective in integrating complex techniques like TSEI into clinical practice. The findings highlight that a systematic framework can help to overcome organizational and technical challenges, thereby enhancing patient care and operational efficiency. Future efforts should continue to employ structured methodologies for the sustainable integration of new medical technologies.