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@ARTICLE{Dapper:299818,
      author       = {H. Dapper and C. Rudroff and P. Linde and J. Rosenbrock and
                      J. Schmitz and S. Ferdinandus and K. Jablonska and D.
                      Martin$^*$ and C. Rödel$^*$ and E. Fokas},
      title        = {{R}adiation therapy in anal high-grade squamous
                      intraepithelial lesions-a pattern of care analysis in
                      {G}erman-speaking countries.},
      journal      = {Strahlentherapie und Onkologie},
      volume       = {201},
      issn         = {0179-7158},
      address      = {Heidelberg},
      publisher    = {Springer Medizin},
      reportid     = {DKFZ-2025-00555},
      pages        = {699–705},
      year         = {2025},
      note         = {Volume 201, pages 699–705, (2025)},
      abstract     = {High-grade squamous intraepithelial lesions (HSIL) of the
                      anal region are recognized as precursor lesions to squamous
                      cell carcinoma of the anus (SCCA), especially in individuals
                      infected with the human papillomavirus (HPV). Although
                      recent studies indicate that treating HSIL can reduce
                      progression to SCCA, optimal management strategies remain
                      undefined. High recurrence rates and treatment-associated
                      morbidities underscore the need for effective therapeutic
                      options.A survey among radiation oncologists in Germany was
                      conducted between September and October 2024, covering
                      clinical practice settings, the frequency of HSIL cases,
                      experience with radiotherapy, reasons for radiotherapy
                      inquiries, treatment indications, and concurrent therapies.A
                      total of 58 radiation oncologists participated in the
                      survey, with 37 $(63.8\%)$ reporting inquiries about
                      radiotherapy for HSIL, primarily for patients with multiple
                      recurrences. Radiotherapy was generally considered an
                      appropriate option, particularly for recurrent cases where
                      other treatments posed risks, especially complications or
                      worsening of anorectal function after local excision.
                      However, only half of the respondents (29) had prior
                      experience with treating anal HSIL and rated radiotherapy
                      outcomes as good or very good. Most respondents indicated a
                      preference for treating only the local area (i.e., excluding
                      lymphatic drainage pathways) to a total dose of 40-50
                      Gy.Recurrent anal HSIL presents a major challenge for
                      patients, with no established effective treatment standards
                      available. Radiotherapy is frequently requested and
                      administered, showing promising preliminary outcomes.
                      Clinical studies are warranted to evaluate the effectiveness
                      and tolerability of radiotherapy in patients with anal
                      HSIL.},
      keywords     = {Anal high-grade squamous intraepithelial lesions (HSIL)
                      (Other) / Pattern of care (Other) / Radiation therapy
                      (Other) / Radiotherapy (Other)},
      cin          = {FM01},
      ddc          = {610},
      cid          = {I:(DE-He78)FM01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40053135},
      doi          = {10.1007/s00066-025-02380-5},
      url          = {https://inrepo02.dkfz.de/record/299818},
}