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@ARTICLE{Lazzeroni:307500,
      author       = {M. Lazzeroni and A. Ureba and H. Schäfer$^*$ and N.
                      Nicolay$^*$ and A. Rühle$^*$ and D. Baltas$^*$ and A. Dasu
                      and P. T. Meyer and M. Mix and I. Toma-Dasu and A. L.
                      Grosu$^*$},
      title        = {{B}iologically {I}ndividualized {R}adiotherapy {B}ased on
                      {PET}: {A} {N}ovel {A}pproach to {T}reatment {O}ptimization
                      of {H}ead and {N}eck {C}ancer.},
      journal      = {Journal of nuclear medicine},
      volume       = {nn},
      issn         = {0097-9058},
      address      = {New York, NY},
      publisher    = {Soc.},
      reportid     = {DKFZ-2026-00005},
      pages        = {nn},
      year         = {2025},
      note         = {epub},
      abstract     = {Current radiotherapy for malignant tumors often adopts a
                      'one-size-fits-all' approach, prescribing the same
                      irradiation dose for patients with similar clinical
                      indications. However, advancements in functional imaging
                      allow for biologically individualized strategies, with dose
                      distribution tailored to the specific tumor biology. This
                      study proposes a novel approach to biologically
                      individualized radiotherapy, exploiting the synergistic
                      combination of the tumor clonogenic cell information from
                      [18F]FDG PET images and radiosensitivity from
                      [18F]fluoromisonidazole (FMISO) PET images. Methods:
                      Twenty-eight patients with head and neck squamous cell
                      carcinoma (HNSCC) were analyzed. Using imaging biomarkers,
                      individualized tumor profiles were obtained from oxygen
                      partial pressure and clonogenic cell density maps derived
                      from [18F]FMISO and [18F]FDG PET, respectively.
                      Dose-escalated radiotherapy plans aiming at $95\%$ tumor
                      control probability (TCP) were generated using automated
                      planning. Plans were assessed for clinical feasibility and
                      expected TCP. Results: Planned dose distributions achieved
                      greater than $90\%$ TCP in all cases. All treatment plans
                      met standard clinical feasibility criteria for the main
                      organs-at-risk constraints, except for the few cases with
                      significant target overlap, demonstrating the overall
                      feasibility of the personalized strategy. Conclusion: The
                      proposed biologically individualized treatment strategy
                      demonstrated feasibility and clinical applicability.
                      Combining [18F]FDG and [18F]FMISO PET imaging potentially
                      shifts the success rate of HNSCC treatment from
                      approximately $60\%$ at 5 y, as reported in the literature,
                      to a projected TCP of $90\%.$ This treatment strategy holds
                      promise for improving patient outcomes through more precise
                      and effective treatment.},
      keywords     = {biologically individualized radiotherapy (Other) /
                      clonogenic cell density (Other) / dual-tracer PET (Other) /
                      head and neck squamous cell carcinoma (Other) / tumor
                      hypoxia (Other)},
      cin          = {FR01},
      ddc          = {610},
      cid          = {I:(DE-He78)FR01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41469160},
      doi          = {10.2967/jnumed.125.270403},
      url          = {https://inrepo02.dkfz.de/record/307500},
}