Letter to the Editor: Reply to Topkan et al

We thank the colleagues Topkan and the co-authors for their valuable comments on our study. As they stated correctly, there for sure are more factors influencing the development of necrosis – nicotine and alcohol might also play an important role, for example. Also some hints point at the distance o...

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Main Authors: Claudia Schweizer, Vratislav Strnad
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Clinical and Translational Radiation Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S240563082500028X
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author Claudia Schweizer
Vratislav Strnad
author_facet Claudia Schweizer
Vratislav Strnad
author_sort Claudia Schweizer
collection DOAJ
description We thank the colleagues Topkan and the co-authors for their valuable comments on our study. As they stated correctly, there for sure are more factors influencing the development of necrosis – nicotine and alcohol might also play an important role, for example. Also some hints point at the distance of the catheters being associated with risk of necrosis. Due to the fact that the risk factors influence each other in their effect on the risk of necrosis and usually have an additive effect and due to the generally retrospective data collections in published articles on interventional radiotherapy in the oral cavity, some risk factors for late side effects cannot be perfectly recorded and evaluated. In our understanding, not only the distance to the mandible, but also the bone volume which is affected by radiation dose must be considered. No specific dose constraints exist for the mandible when applying interventional radiotherapy. We are currently analyzing further dose parameters available within CT-based planning workflows and hope for more detailed information on how we can improve the implants. Nevertheless, prospective data is needed to sufficiently address toxicity issues in a larger cohort of patients with long-term follow-up. As far as the disease-free survival is concerned, we indeed estimated this according to the current practice in several other published data without taking the event of death into account. This is obvious when looking at our results. Still, we agree that the different ways of presenting freedom of recurrence throughout the literature makes comparison rather difficult and should be unified. We thank you for your remark and will consider this in our future work.
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spelling doaj-art-faa94ee7e233443abc0da47c2983e0a22025-08-20T02:59:50ZengElsevierClinical and Translational Radiation Oncology2405-63082025-05-015210093810.1016/j.ctro.2025.100938Letter to the Editor: Reply to Topkan et alClaudia Schweizer0Vratislav Strnad1Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; Corresponding author at: Universitätsklinikum Erlangen, Department of Radiation Oncology, Universitätsstr. 27, 91054 Erlangen, Germany.Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, GermanyWe thank the colleagues Topkan and the co-authors for their valuable comments on our study. As they stated correctly, there for sure are more factors influencing the development of necrosis – nicotine and alcohol might also play an important role, for example. Also some hints point at the distance of the catheters being associated with risk of necrosis. Due to the fact that the risk factors influence each other in their effect on the risk of necrosis and usually have an additive effect and due to the generally retrospective data collections in published articles on interventional radiotherapy in the oral cavity, some risk factors for late side effects cannot be perfectly recorded and evaluated. In our understanding, not only the distance to the mandible, but also the bone volume which is affected by radiation dose must be considered. No specific dose constraints exist for the mandible when applying interventional radiotherapy. We are currently analyzing further dose parameters available within CT-based planning workflows and hope for more detailed information on how we can improve the implants. Nevertheless, prospective data is needed to sufficiently address toxicity issues in a larger cohort of patients with long-term follow-up. As far as the disease-free survival is concerned, we indeed estimated this according to the current practice in several other published data without taking the event of death into account. This is obvious when looking at our results. Still, we agree that the different ways of presenting freedom of recurrence throughout the literature makes comparison rather difficult and should be unified. We thank you for your remark and will consider this in our future work.http://www.sciencedirect.com/science/article/pii/S240563082500028XEarly-stage oral cavity cancerPostoperative radiotherapyInterventional radiotherapyLong-term toxicity after brachytherapy
spellingShingle Claudia Schweizer
Vratislav Strnad
Letter to the Editor: Reply to Topkan et al
Clinical and Translational Radiation Oncology
Early-stage oral cavity cancer
Postoperative radiotherapy
Interventional radiotherapy
Long-term toxicity after brachytherapy
title Letter to the Editor: Reply to Topkan et al
title_full Letter to the Editor: Reply to Topkan et al
title_fullStr Letter to the Editor: Reply to Topkan et al
title_full_unstemmed Letter to the Editor: Reply to Topkan et al
title_short Letter to the Editor: Reply to Topkan et al
title_sort letter to the editor reply to topkan et al
topic Early-stage oral cavity cancer
Postoperative radiotherapy
Interventional radiotherapy
Long-term toxicity after brachytherapy
url http://www.sciencedirect.com/science/article/pii/S240563082500028X
work_keys_str_mv AT claudiaschweizer lettertotheeditorreplytotopkanetal
AT vratislavstrnad lettertotheeditorreplytotopkanetal