{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T22:15:12Z","timestamp":1770243312336,"version":"3.49.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinische Hochschule Hannover (MHH)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Strahlenther Onkol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Locally advanced breast cancer in frail and inoperable patients often causes tumor-associated pain, bleeding, or discharge. These patients may not be suitable for therapeutic options like surgery or potentially toxic systemic treatment. Local radiotherapy with little impact on treatment time may be beneficial in this patient subgroup. We evaluated an ultra-hypofractionated definitive irradiation concept in five fractions (5\u202f\u00d7\u20095\u202fGy with a\u00a0simultaneous integrated boost of 5\u202f\u00d7\u20096\u202fGy) for these patients, focusing on tolerability and clinical outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A\u00a0total of 29\u00a0patients were retrospectively sampled. They were treated by irradiation to the breast with 25\u202fGy in five fractions with a\u00a0simultaneous integrated boost (SIB) of 6\u202fGy per fraction. Tumor response and clinical outcome were evaluated by clinical examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 27\u00a0patients with a\u00a0median age of 82\u00a0years were assessed. Median follow-up was 7.4\u00a0months. All patients completed radiotherapy with 25\u202fGy in five fractions with a\u00a0simultaneous integrated boost of 30\u202fGy (6\u202fGy per fraction) without any high-grade toxicity (\u2265\u202fgrade\u00a02). Within the first 90\u00a0days after irradiation, 15\u00a0patients (56%) exhibited a\u00a0clinical response and 12 showed stable disease. Only 7\u00a0patients reported low-grade acute dermatotoxicity grade\u00a01 (CTCAE) within the first 90\u00a0days, and only one experienced toxicity later (fibrosis grade\u00a01, LENT-SOMA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Radiotherapy in five consecutive daily fractions is sufficient. The studied regimen proved to be a\u00a0safe, effective palliative treatment in inoperable and frail patients not suitable for surgery or toxic systemic therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00066-025-02445-5","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T12:34:32Z","timestamp":1758630872000},"page":"178-186","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Locally advanced breast cancer: primary ultra-hypofractionated radiotherapy for inoperable or frail patients"],"prefix":"10.1007","volume":"202","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2478-4638","authenticated-orcid":false,"given":"Anne Caroline","family":"Kn\u00f6chelmann","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Merten","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans","family":"Christiansen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elna","family":"Kuehnle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Meinecke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,23]]},"reference":[{"key":"2445_CR1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.annonc.2019.10.012","volume":"1","author":"J Heil","year":"2020","unstructured":"Heil\u00a0J, Kuerer\u00a0HM, Pfob\u00a0A, Rauch\u00a0G, Sinn\u00a0HP, Golatta\u00a0M, Liefers\u00a0GJ, Vrancken Peeters\u00a0MJ (2020) Eliminating the breast cancer surgery paradigm after neoadjuvant systemic therapy: current evidence and future challenges. 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Int J Radiat Oncol Biol Phys 122(2):278\u2013291. https:\/\/doi.org\/10.1016\/j.ijrobp.2024.11.065","journal-title":"Int J Radiat Oncol Biol Phys"}],"container-title":["Strahlentherapie und Onkologie"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00066-025-02445-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00066-025-02445-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00066-025-02445-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T09:06:26Z","timestamp":1770195986000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00066-025-02445-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,23]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["2445"],"URL":"https:\/\/doi.org\/10.1007\/s00066-025-02445-5","relation":{},"ISSN":["0179-7158","1439-099X"],"issn-type":[{"value":"0179-7158","type":"print"},{"value":"1439-099X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,23]]},"assertion":[{"value":"21 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"A.C.\u00a0Kn\u00f6chelmann, R.\u00a0Merten, H.\u00a0Christiansen, E.\u00a0Kuehnle, and D.\u00a0Meinecke declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the institutional ethical review board of Hannover Medical School (no. 11503_BO_K_2024).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}