@article{TreutweinStegerLoescheletal., author = {Treutwein, Marius and Steger, Felix and L{\"o}schel, Rainer and K{\"o}lbl, Oliver and Dobler, Barbara}, title = {The influence of radiotherapy techniques on the plan quality and on the risk of secondary tumors in patients with pituitary adenoma}, series = {BMC cancer}, volume = {20}, journal = {BMC cancer}, publisher = {Springer}, doi = {10.1186/s12885-020-6535-y}, pages = {1 -- 13}, abstract = {BACKGROUND: This planning study compares different radiotherapy techniques for patients with pituitary adenoma, including flatness filter free mode (FFF), concerning plan quality and secondary malignancies for potentially young patients. The flatness filter has been described as main source of photon scatter. MATERIAL AND METHODS: Eleven patients with pituitary adenoma were included. An Elekta Synergy™ linac was used in the treatment planning system Oncentra® and for the measurements. 3D plans, IMRT, and VMAT plans and non-coplanar varieties were considered. The plan quality was evaluated regarding homogeneity, conformity, delivery time and dose to the organs at risk. The secondary malignancy risk was calculated from dose volume data and from measured dose to the periphery using different models for carcinoma and sarcoma risk. RESULTS: The homogeneity and conformity were nearly unchanged with and without flattening filter, neither was the delivery time found substantively different. VMAT plans were more homogenous, conformal and faster in delivery than IMRT plans. The secondary cancer risk was reduced with FFF both in the treated region and in the periphery. VMAT plans resulted in a higher secondary brain cancer risk than IMRT plans, but the risk for secondary peripheral cancer was reduced. Secondary sarcoma risk plays a minor role. No advantage was found for non-coplanar techniques. The FFF delivery times were not shortened due to additional monitor units needed and technical limitations. The risk for secondary brain cancer seems to depend on the irradiated volume. Secondary sarcoma risk is much smaller than carcinoma risk in accordance to the results of the atomic bomb survivors. The reduction of the peripheral dose and resulting secondary malignancy risk for FFF is statistically significant. However, it is negligible in comparison to the risk in the treated region. CONCLUSION: Treatments with FFF can reduce secondary malignancy risk while retaining similar quality as with flattening filter and should be preferred. VMAT plans show the best plan quality combined with lowest peripheral secondary malignancy risk, but highest level of second brain cancer risk. Taking this into account VMAT FFF seems the most advantageous technique for the treatment of pituitary adenomas with the given equipment.}, language = {en} } @misc{MauererRexhepajMonkmanetal., author = {Mauerer, Wolfgang and Rexhepaj, Tanja and Monkman, Gareth J. and Sindersberger, Dirk and Diermeier, Andreas and Neidhart, Thomas and Wolfrum, Dominik and Sterner, Michael and Heberl, Michael and Nusko, Robert and Maier, Georg and Nagl, Klaus and Reuter, Monika and Hofrichter, Andreas and Lex, Thomas and Lesch, Florian and Kieninger, B{\"a}rbel and Szalo, Alexander Eduard and Zehner, Alexander and Palm, Christoph and Joblin, Mitchell and Apel, Sven and Ramsauer, Ralf and Lohmann, Daniel and Westner, Markus and Strasser, Artur and Munndi, Maximilian and Ebner, Lena and Elsner, Michael and Weiß, Nils and Segerer, Matthias and Hackenberg, Rudolf and Steger, Sebastian and Schmailzl, Anton and Dostalek, Michael and Armbruster, Dominik and Koch, Fabian and Hierl, Stefan and Thumann, Philipp and Swidergal, Krzysztof and Wagner, Marcus and Briem, Ulrich and Diermeier, Andreas and Spreitzer, Stefan and Beiderbeck, Sabrina and Hook, Christian and Zobel, Martin and Weber, Tim and Groß, Simon and Penzkofer, Rainer and Dendorfer, Sebastian and Schillitz, Ingo and Bauer, Thomas and Rudolph, Clarissa and Schmidt, Katja and Liebetruth, Thomas and Hamer, Markus and Haug, Sonja and Vernim, Matthias and Weber, Karsten and Saßmannshausen, Sean Patrick and Books, Sebastian and Neuleitner, Nikolaus and Rechenauer, Christian and Steffens, Oliver and Kusterle, Wolfgang and G{\"o}mmel, Roland and Wellnitz, Felix and Stierstorfer, Johannes and Stadler, Dominik and Hofmann, Matthias J. and Motschmann, Hubert and Shamonin (Chamonine), Mikhail and Bleicher, Veronika and Fischer, Sebastian and Hackenberg, Rudolf and Horn, Anton and Kawasch, Raphael and Petzenhauser, Michael and Probst, Tobias and Udalzow, Anton and Dams, Florian and Schreiner, Rupert and Langer, Christoph and Prommesberger, Christian and Ławrowski, Robert Damian}, title = {Forschungsbericht 2016}, editor = {Baier, Wolfgang}, address = {Regensburg}, organization = {Ostbayerische Technische Hochschule Regensburg}, doi = {10.35096/othr/pub-1384}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-13840}, language = {de} }