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Book ; Thesis: Strahlenbiologische Untersuchung von Dosisrateneffekten bei der intensitätsmodulierten Strahlentherapie

Sterzing, Florian

2005

Author's details	vorgelegt von Florian Sterzing
Language	German
Size	100 Bl. : Ill., graph. Darst.
Publishing country	Germany
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Heidelberg, Univ., Diss., 2005
HBZ-ID	HT014509245
Database	Catalogue ZB MED Medicine, Health

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2005 E 1435	order for loan	Magazin

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Article ; Online: A treatment planning study of combined carbon ion-beam plus photon intensity-modulated radiotherapy.

Schuppert, Christopher / Paul, Angela / Nill, Simeon / Schwahofer, Andrea / Debus, Jürgen / Sterzing, Florian

Physics and imaging in radiation oncology

2020 Volume 15, Page(s) 16–22

Abstract: Background and purpose: Combined photon intensity-modulated radiotherapy (IMRT) and sequential dose-escalated carbon ion beam therapy (IBT) is a technically advanced treatment option for head and neck malignancies. We proposed and evaluated an ... ...

Abstract	Background and purpose: Combined photon intensity-modulated radiotherapy (IMRT) and sequential dose-escalated carbon ion beam therapy (IBT) is a technically advanced treatment option for head and neck malignancies. We proposed and evaluated an integrated planning strategy as opposed to an established and largely separated planning workflow. Materials and methods: Ten patients with representative malignancies of the head and neck region underwent combined carbon-photon radiotherapy (RT) in our facilities. Clinical plans were created according to the separated workflow with independent optimization stages for both modalities. Experimental plans incorporated the existing carbon IBT dose distribution into the optimization stage of a step-and-shoot photon IMRT (bias dose planning). Results: Cumulative dose distributions showed statistically significant differences between the two planning strategies and were predominantly in favor of the integrated approach. As such, target irradiation was generally maintained or even improved in a subset of metrics, while normal tissue sparing was widely enhanced; for instance, in the ipsilateral temporal lobe with median D Conclusions: Our findings indicate that combination planning of carbon-photon RT for head and neck malignancies may benefit from a proposed bias dose method, yielding favorable dose distribution characteristics and a streamlined planning workflow with fewer plan revisions. Further research is necessary to validate these observations in terms of robustness and their potential for higher tumor control.
Language	English
Publishing date	2020-07-10
Publishing country	Netherlands
Document type	Journal Article
ISSN	2405-6316
ISSN (online)	2405-6316
DOI	10.1016/j.phro.2020.06.008
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Design and Selection of Machine Learning Methods Using Radiomics and Dosiomics for Normal Tissue Complication Probability Modeling of Xerostomia.

Gabryś, Hubert S / Buettner, Florian / Sterzing, Florian / Hauswald, Henrik / Bangert, Mark

Frontiers in oncology

2018 Volume 8, Page(s) 35

Abstract: Purpose: The purpose of this study is to investigate whether machine learning with dosiomic, radiomic, and demographic features allows for xerostomia risk assessment more precise than normal tissue complication probability (NTCP) models based on the ... ...

Abstract	Purpose: The purpose of this study is to investigate whether machine learning with dosiomic, radiomic, and demographic features allows for xerostomia risk assessment more precise than normal tissue complication probability (NTCP) models based on the mean radiation dose to parotid glands. Material and methods: A cohort of 153 head-and-neck cancer patients was used to model xerostomia at 0-6 months (early), 6-15 months (late), 15-24 months (long-term), and at any time (a longitudinal model) after radiotherapy. Predictive power of the features was evaluated by the area under the receiver operating characteristic curve (AUC) of univariate logistic regression models. The multivariate NTCP models were tuned and tested with single and nested cross-validation, respectively. We compared predictive performance of seven classification algorithms, six feature selection methods, and ten data cleaning/class balancing techniques using the Friedman test and the Nemenyi Results: NTCP models based on the parotid mean dose failed to predict xerostomia (AUCs < 0.60). The most informative predictors were found for late and long-term xerostomia. Late xerostomia correlated with the contralateral dose gradient in the anterior-posterior (AUC = 0.72) and the right-left (AUC = 0.68) direction, whereas long-term xerostomia was associated with parotid volumes (AUCs > 0.85), dose gradients in the right-left (AUCs > 0.78), and the anterior-posterior (AUCs > 0.72) direction. Multivariate models of long-term xerostomia were typically based on the parotid volume, the parotid eccentricity, and the dose-volume histogram (DVH) spread with the generalization AUCs ranging from 0.74 to 0.88. On average, support vector machines and extra-trees were the top performing classifiers, whereas the algorithms based on logistic regression were the best choice for feature selection. We found no advantage in using data cleaning or class balancing methods. Conclusion: We demonstrated that incorporation of organ- and dose-shape descriptors is beneficial for xerostomia prediction in highly conformal radiotherapy treatments. Due to strong reliance on patient-specific, dose-independent factors, our results underscore the need for development of personalized data-driven risk profiles for NTCP models of xerostomia. The facilitated machine learning pipeline is described in detail and can serve as a valuable reference for future work in radiomic and dosiomic NTCP modeling.
Language	English
Publishing date	2018-03-05
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2018.00035
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Article ; Online: A treatment planning study of combined carbon ion-beam plus photon intensity-modulated radiotherapy

Christopher Schuppert / Angela Paul / Simeon Nill / Andrea Schwahofer / Jürgen Debus / Florian Sterzing

Physics and Imaging in Radiation Oncology, Vol 15, Iss , Pp 16-

2020 Volume 22

Abstract	Background and purpose: Combined photon intensity-modulated radiotherapy (IMRT) and sequential dose-escalated carbon ion beam therapy (IBT) is a technically advanced treatment option for head and neck malignancies. We proposed and evaluated an integrated planning strategy as opposed to an established and largely separated planning workflow. Materials and methods: Ten patients with representative malignancies of the head and neck region underwent combined carbon-photon radiotherapy (RT) in our facilities. Clinical plans were created according to the separated workflow with independent optimization stages for both modalities. Experimental plans incorporated the existing carbon IBT dose distribution into the optimization stage of a step-and-shoot photon IMRT (bias dose planning). Results: Cumulative dose distributions showed statistically significant differences between the two planning strategies and were predominantly in favor of the integrated approach. As such, target irradiation was generally maintained or even improved in a subset of metrics, while normal tissue sparing was widely enhanced; for instance, in the ipsilateral temporal lobe with median Dmean of −16% (p < 0.001). Maximum doses D1% (with adjustment for different fractionation) fell below thresholds for toxicity risk in a minority of instances, where they were previously exceeded. Integral dose did not differ significantly. Conclusions: Our findings indicate that combination planning of carbon-photon RT for head and neck malignancies may benefit from a proposed bias dose method, yielding favorable dose distribution characteristics and a streamlined planning workflow with fewer plan revisions. Further research is necessary to validate these observations in terms of robustness and their potential for higher tumor control.
Keywords	Radiotherapy ; Combined modality therapy ; Heavy ion radiotherapy ; Intensity-modulated ; Radiotherapy planning ; Computer-assisted ; Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
Subject code	616
Language	English
Publishing date	2020-07-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Parotid gland mean dose as a xerostomia predictor in low-dose domains.

Gabryś, Hubert Szymon / Buettner, Florian / Sterzing, Florian / Hauswald, Henrik / Bangert, Mark

Acta oncologica (Stockholm, Sweden)

2017 Volume 56, Issue 9, Page(s) 1197–1203

Abstract: Purpose: Xerostomia is a common side effect of radiotherapy resulting from excessive irradiation of salivary glands. Typically, xerostomia is modeled by the mean dose-response characteristic of parotid glands and prevented by mean dose constraints to ... ...

Abstract	Purpose: Xerostomia is a common side effect of radiotherapy resulting from excessive irradiation of salivary glands. Typically, xerostomia is modeled by the mean dose-response characteristic of parotid glands and prevented by mean dose constraints to either contralateral or both parotid glands. The aim of this study was to investigate whether normal tissue complication probability (NTCP) models based on the mean radiation dose to parotid glands are suitable for the prediction of xerostomia in a highly conformal low-dose regime of modern intensity-modulated radiotherapy (IMRT) techniques. Material and methods: We present a retrospective analysis of 153 head and neck cancer patients treated with radiotherapy. The Lyman Kutcher Burman (LKB) model was used to evaluate predictive power of the parotid gland mean dose with respect to xerostomia at 6 and 12 months after the treatment. The predictive performance of the model was evaluated by receiver operating characteristic (ROC) curves and precision-recall (PR) curves. Results: Average mean doses to ipsilateral and contralateral parotid glands were 25.4 Gy and 18.7 Gy, respectively. QUANTEC constraints were met in 74% of patients. Mild to severe (G1+) xerostomia prevalence at both 6 and 12 months was 67%. Moderate to severe (G2+) xerostomia prevalence at 6 and 12 months was 20% and 15%, respectively. G1 + xerostomia was predicted reasonably well with area under the ROC curve ranging from 0.69 to 0.76. The LKB model failed to provide reliable G2 + xerostomia predictions at both time points. Conclusions: Reduction of the mean dose to parotid glands below QUANTEC guidelines resulted in low G2 + xerostomia rates. In this dose domain, the mean dose models predicted G1 + xerostomia fairly well, however, failed to recognize patients at risk of G2 + xerostomia. There is a need for the development of more flexible models able to capture complexity of dose response in this dose regime.
Language	English
Publishing date	2017-09
Publishing country	England
Document type	Journal Article
ZDB-ID	896449-x
ISSN	1651-226X ; 0349-652X ; 0284-186X ; 1100-1704
ISSN (online)	1651-226X
ISSN	0349-652X ; 0284-186X ; 1100-1704
DOI	10.1080/0284186X.2017.1324209
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Article: Whole-brain helical tomotherapy with integrated boost for brain metastases in patients with malignant melanoma - final results of the BRAIN-RT trial.

Hauswald, Henrik / Bernhardt, Denise / Krug, David / Katayama, Sonja / Habl, Gregor / Lorenzo Bermejo, Justo / Debus, Jürgen / Sterzing, Florian

Cancer management and research

2019 Volume 11, Page(s) 4669–4676

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2019-05-24
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2508013-1
ISSN	1179-1322
ISSN	1179-1322
DOI	10.2147/CMAR.S204729
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Article ; Online: Technical Note: On the size of susceptibility-induced MR image distortions in prostate and cervix in the context of MR-guided radiation therapy.

Emmerich, Julian / Laun, Frederik B / Pfaffenberger, Asja / Schilling, Rebecca / Denoix, Michael / Maier, Florian / Sterzing, Florian / Bostel, Tilman / Straub, Sina

Medical physics

2018 Volume 45, Issue 4, Page(s) 1586–1593

Abstract: Purpose: To investigate the extent of MR image distortions in the pelvis caused by susceptibility-induced field inhomogeneities in MR images in the context of a study on MR-guided radiotherapy.: Methods: Using a high-bandwidth double-echo gradient ... ...

Abstract	Purpose: To investigate the extent of MR image distortions in the pelvis caused by susceptibility-induced field inhomogeneities in MR images in the context of a study on MR-guided radiotherapy. Methods: Using a high-bandwidth double-echo gradient echo sequence, field maps and distortion maps of the pelvis were calculated and evaluated for 219 exams (92 of female and 127 of male patients) to investigate patient-related image distortions caused by susceptibility differences in an ongoing study on MR-guided radiotherapy. The evaluation of distortions in the regions "rectum", "prostate", "cervix", and in a reference region in the gluteus maximus was based on masks drawn by two readers. Results: Distortions in the prostate and cervix were smaller than 0.03 px (0.1 mm) for 99% of voxels, and reached a maximum value of 0.09 px (0.3 mm). In the reference region, maximum distortions were smaller than in the prostate and cervix. Conclusions: Using a geometric uncertainty of 0.2 px (0.6 mm) in margin definition for organs that are close to the rectum like the prostate and the cervix would be a cautious choice to account for susceptibility-induced distortions that can arise during MR-based treatment guidance for the imaging setting used in this study. Since distortions are inversely proportional to the readout bandwidth of the sequence, safety margins need to be adapted adequately. Additional sources of image distortions like gradient nonlinearities are not included in our margin recommendations and should be considered separately.
MeSH term(s)	Artifacts ; Cervix Uteri/diagnostic imaging ; Female ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging ; Male ; Phantoms, Imaging ; Prostate/diagnostic imaging ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Image-Guided
Language	English
Publishing date	2018-03-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	188780-4
ISSN	2473-4209 ; 0094-2405
ISSN (online)	2473-4209
ISSN	0094-2405
DOI	10.1002/mp.12785
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Article ; Online: Interactive dose shaping part 2: proof of concept study for six prostate patients.

Ph Kamerling, Cornelis / Ziegenhein, Peter / Sterzing, Florian / Oelfke, Uwe

Physics in medicine and biology

2016 Volume 61, Issue 6, Page(s) 2471–2484

Abstract: Recently we introduced interactive dose shaping (IDS) as a new IMRT planning strategy. This planning concept is based on a hierarchical sequence of local dose modification and recovery operations. The purpose of this work is to provide a feasibility ... ...

Abstract	Recently we introduced interactive dose shaping (IDS) as a new IMRT planning strategy. This planning concept is based on a hierarchical sequence of local dose modification and recovery operations. The purpose of this work is to provide a feasibility study for the IDS planning strategy based on a small set of six prostate patients. The IDS planning paradigm aims to perform interactive local dose adaptations of an IMRT plan without compromising already established valuable dose features in real-time. Various IDS tools were developed in our in-house treatment planning software Dynaplan and were utilized to create IMRT treatment plans for six patients with an adeno-carcinoma of the prostate. The sequenced IDS treatment plans were compared to conventionally optimized clinically approved plans (9 beams, co-planar). For each patient, several IDS plans were created, with different trade-offs between organ sparing and target coverage. The reference dose distributions were imported into Dynaplan. For each patient, the IDS treatment plan with a similar or better trade-off between target coverage and OAR sparing was selected for plan evaluation, guided by a physician. For this initial study we were able to generate treatment plans for prostate geometries in 15-45 min. Individual local dose adaptations could be performed in less than one second. The average differences compared to the reference plans were for the mean dose: 0.0 Gy (boost) and 1.2 Gy (PTV), for D98% : -1.1 Gy and for D2% : 1.1 Gy (both target volumes). The dose-volume quality indicators were well below the Quantec constraints. However, we also observed limitations of our currently implemented approach. Most prominent was an increase of the non-tumor integral dose by 16.4% on average, demonstrating that further developments of our planning strategy are required.
MeSH term(s)	Feasibility Studies ; Humans ; Male ; Middle Aged ; Prostatic Neoplasms/radiotherapy ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy Planning, Computer-Assisted/standards ; Software
Language	English
Publishing date	2016-03-07
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	208857-5
ISSN	1361-6560 ; 0031-9155
ISSN (online)	1361-6560
ISSN	0031-9155
DOI	10.1088/0031-9155/61/6/2471
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Article ; Online: Overcoming radioresistance in WiDr cells with heavy ion irradiation and radiosensitization by 2-deoxyglucose with photon irradiation.

Hasse, Felix Christian / Koerber, Stefan Alexander / Prigge, Elena Sophie / Liermann, Jakob / von Knebel Doeberitz, Magnus / Debus, Juergen / Sterzing, Florian

Clinical and translational radiation oncology

2019 Volume 19, Page(s) 52–58

Abstract: Background and purpose: Radiosensitizers and heavy ion irradiation could improve therapy for female patients with malignant tumors located in the pelvic region through dose reduction. Aim of the study was to investigate the radiosensitizing potential of ...

Abstract	Background and purpose: Radiosensitizers and heavy ion irradiation could improve therapy for female patients with malignant tumors located in the pelvic region through dose reduction. Aim of the study was to investigate the radiosensitizing potential of 2-deoxy-d-glucose (2-DG) in combination with carbon ion-irradiation ( Materials and methods: The human cervix carcinoma cell line CaSki and the colorectal carcinoma cell line WiDr were used. 2-DG was employed in two different settings, pretreatment and treatment simultaneous to irradiation. Clonogenic survival, α and β values for application of the linear quadratic model and relative biological effectiveness (RBE) were determined. ANOVA tests were used for statistical group comparison. Isobolograms were generated for curve comparisons. Results: The comparison of monotherapy with Conclusion: The combination of 2-DG and photon therapy, as well as irradiation with carbon ions can overcome radioresistance of tumor cells such as WiDr.
Language	English
Publishing date	2019-08-20
Publishing country	Ireland
Document type	Journal Article
ISSN	2405-6308
ISSN (online)	2405-6308
DOI	10.1016/j.ctro.2019.08.003
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Evaluation of Dosimetric Robustness of Carbon Ion Boost Therapy for Anal Carcinoma.

Kraus, Kim Melanie / Pfaffenberger, Asja / Jäkel, Oliver / Debus, Jürgen / Sterzing, Florian

International journal of particle therapy

2017 Volume 3, Issue 3, Page(s) 382–391

Abstract: Purpose: The radiation therapy treatment outcome of human papillomavirus-negative anal carcinoma may be improved by the biological effectiveness of carbon ions. However, abdominal tissue motion can compromise the precision of carbon ion therapy. This ... ...

Abstract	Purpose: The radiation therapy treatment outcome of human papillomavirus-negative anal carcinoma may be improved by the biological effectiveness of carbon ions. However, abdominal tissue motion can compromise the precision of carbon ion therapy. This work aims to evaluate the dosimetric feasibility of carbon ion boost (CIB) therapy for anal carcinoma. Materials and methods: An algorithm to generate computed tomographies based on daily magnetic resonance imaging data and deformable image registration was developed. By means of this algorithm, fractional computed tomography data for 54 treatment fractions for 3 different patients with anal carcinoma were derived. The dose for a sequential CIB (CIB Results: For the investigated patient cases, similar dosimetric results for CIB Conclusion: This study shows the dosimetric feasibility of CIB therapy for anal carcinoma for the first time and gives reason for clinical exploitation of the enhanced biological effect of carbon ions for patients with human papillomavirus-negative anal cancer.
Language	English
Publishing date	2017-03-14
Publishing country	United States
Document type	Journal Article
ISSN	2331-5180
ISSN (online)	2331-5180
DOI	10.14338/IJPT-16-00028.1
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