{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T11:36:50Z","timestamp":1793533010136,"version":"4.5.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T00:00:00Z","timestamp":1650412800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T00:00:00Z","timestamp":1650412800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Frankfurt"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Strahlenther Onkol"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>As the population ages, the incidence of rectal cancer among elderly patients is rising. Due to the risk of perioperative morbidity and mortality, alternative nonoperative treatment options have been explored in elderly and frail patients who are clinically inoperable or refuse surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Here we present technical considerations and first clinical experience after treating a\u00a0cohort of six rectal cancer patients (T1\u20113, N0\u20111, M0; UICC stage\u00a0I-IIIB) with definitive external-beam radiation therapy (EBRT) followed by image-guided, endorectal high-dose-rate brachytherapy (HDR-BT). Patients were treated with 10\u201313\u202f\u00d7\u20093\u202fGy EBRT followed by HDR-BT delivering 12\u201318\u202fGy in two or three fractions. Tumor response was evaluated using endoscopy and magnetic resonance imaging of the pelvis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Median age was 84\u00a0years. All patients completed EBRT and HDR-BT without any high-grade toxicity (&gt;\u202fgrade\u00a02). One patient experienced rectal bleeding (grade\u00a02) after 10\u00a0weeks. Four patients (67%) demonstrated clinical complete response (cCR) or near cCR, there was one partial response, and one residual tumor and hepatic metastasis 8\u00a0weeks after HDR-BT. The median follow-up time for all six patients is 42\u00a0weeks (range 8\u201360\u00a0weeks). Sustained cCR without evidence of local regrowth has been achieved in all four patients with initial (n)cCR to date.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Primary EBRT combined with HDR-BT is feasible and well tolerated with promising response rates in elderly and frail rectal cancer patients. The concept could be an integral part of a\u00a0highly individualized and selective nonoperative treatment offered to patients who are not suitable for or refuse surgery.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00066-022-01931-4","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T05:02:40Z","timestamp":1650517360000},"page":"654-662","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Image-guided high-dose-rate brachytherapy for rectal cancer: technical note and first clinical experience on an organ-preserving approach"],"prefix":"10.1007","volume":"198","author":[{"given":"Maximilian","family":"Fleischmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Diefenhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Trommel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Scherf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulla","family":"Ramm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Chatzikonstantinou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil","family":"Fokas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"R\u00f6del","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Tselis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,4,20]]},"reference":[{"issue":"1","key":"1931_CR1","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/S1470-2045(20)30555-6","volume":"22","author":"RR Bahadoer","year":"2021","unstructured":"Bahadoer\u00a0RR, Dijkstra\u00a0EA, van Etten\u00a0B, Marijnen\u00a0CAM, Putter\u00a0H, Kranenbarg\u00a0EM\u2011K, Roodvoets\u00a0AGH, Nagtegaal\u00a0ID, Beets-Tan\u00a0RGH, Blomqvist\u00a0LK, Fokstuen\u00a0T, Ten\u00a0TAJ, Capdevila\u00a0J, Hendriks\u00a0MP, Edhemovic\u00a0I, Cervantes\u00a0A, Nilsson\u00a0PJ, Glimelius\u00a0B, van de Velde\u00a0CJH, Hospers\u00a0GAP (2021) Short-course radiotherapy followed by chemotherapy before Total Mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial. 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