Search Results (335)

Low temperature combined with fluctuating irradiance frequently co-occurs and suppresses photosynthesis, with irreversible injury to photosystem I (PSI) recognized as a key constraint on growth and yield. To test whether exogenous hydrogen sulfide (H₂S) mitigates this “cold–fluctuating light” stress in mulberry, we established six treatment combinations (room temperature controls, sodium hydrosulfide, and hypotaurine, each with or without low temperature plus fluctuating light). We quantified PSI/PSII photochemical properties, gas exchange, reactive oxygen species (ROS), and antioxidant enzyme activities. Under cold with fluctuating light, PSI was strongly inhibited: Y_NA increased, whereas Y_I and ΔI/I_o decreased, and the P700 re-reduction half-time (t½) was prolonged (ANOVA, Tukey’s HSD, p < 0.05), indicating pronounced acceptor-side over-reduction and impaired electron transport. PSII performance also declined (lower F_v/F_m and PI_ABS, higher ΔV_J; p < 0.05). NaHS pretreatment significantly alleviated these effects relative to the stressed control: PSI/PSII metrics partly recovered, net photosynthetic rate (P_n) and water-use efficiency (WUE) increased, H₂O₂ and MDA decreased, and SOD/POD/CAT activities rose (p < 0.05). Notably, NPQ_high correlated negatively with Y_NA (Pearson r < 0, p < 0.001), consistent with the notion that enhanced energy dissipation relieves PSI acceptor-side limitation. We propose that exogenous H₂S stabilizes electron transport and supports carbon assimilation via a dual strategy—faster engagement of energy dissipation and activation of antioxidant defenses—highlighting its potential utility for managing stress in fruit crops under erratic early-season weather. Full article

Europe, including Poland, is undergoing an energy transition. The use of renewable energy sources (RES) in the national energy sector is increasing significantly, and previously unused areas are increasingly developed for photovoltaic power plants. A specific type of housing common in Eastern European countries opens an additional opportunity for photovoltaic installations without occupying usable ground area. This article aims to analyze the potential for utilizing balconies and loggias in large-panel buildings, which are characteristic of major cities in Poland. Approximately 30% of the population resides in such housing. This presents significant potential for direct use of renewable energy by apartment residents. The article also explores the legal framework for such installations, both as individual investments by apartment owners and as collective initiatives managed by building administrators. The authors analyzed the potential performance of photovoltaic installations under varying azimuths and tilt angles, considering solar irradiation potential. The analyses also encompassed different photovoltaic module technologies, covering a spectrum of photovoltaic technologies, from commonly used monocrystalline panels to advanced transparent BIPV (Building-Integrated Photovoltaics) solutions. Furthermore, the study quantified the energy potential of such installations and compared the results with existing photovoltaic capacities and electricity demand in Poland. Full article

Oily wastewater poses severe ecological and health threats, but conventional separation technologies have limitations like low efficiency or high energy consumption. Herein, two superwettable carbon fiber (CF)-based membranes were fabricated for efficient oil–water separation. Using CF (low cost, excellent mechanical stability) as the substrate, Cu-TiO₂@CF (superhydrophilic/underwater superoleophobic, renewable) was prepared via a deep ultraviolet (DUV)-assisted sol–gel method, and OTMS/Cu-TiO₂@CF (superhydrophobic/superoleophilic) was obtained by modifying Cu-TiO₂@CF with octadecyltrimethoxysilane (OTMS) via hydrothermal synthesis. Characterization showed Cu-TiO₂ coatings uniformly covered CF, with strong substrate bonding. Both membranes exhibited outstanding performance: Cu-TiO₂@CF achieved water fluxes of up to 79,839.6 L·m⁻²·h⁻¹ and >97.3% separation efficiency for four oil–water mixtures; OTMS/Cu-TiO₂@CF had a maximum oil flux of 86,593.4 L·m⁻²·h⁻¹ and >98.1% efficiency. Cu-TiO₂@CF regenerated via 10 min UV irradiation (restoring underwater oil contact angle to 153°), while OTMS/Cu-TiO₂@CF achieved recovery through the process of UV irradiation followed by OTMS re-modification. Both membranes maintained stable performance over 100 cycles, demonstrating considerable potential for engineering applications. Full article

Background: Radiation necrosis (RN) is a delayed and potentially debilitating complication of radiotherapy for central nervous system (CNS) tumors. It presents significant diagnostic and therapeutic challenges due to the variable clinical manifestations and overlap with tumor recurrence. Although advances in radiotherapy have improved tumor control, RN remains incompletely understood and inadequately addressed. This narrative review synthesizes current evidence on RN pathophysiology, risk factors, diagnostic strategies, and management approaches. Methods: A literature search was conducted for English-language literature published between January 1990 and December 2024. Studies were included if they addressed RN incidence, diagnosis, treatment, or novel preventive strategies in CNS tumor populations. Relevant findings were synthesized to produce a narrative review summarizing pathophysiology, diagnostic challenges, and treatment strategies. Results: RN results from radiation-induced neurovascular injury, inflammation, and vessel permeability, with incidence ranging from 3 to 26% depending on tumor type, location, and treatment parameters. Risk is influenced by dose, fractionation, cumulative exposure, re-irradiation, and adjuvant therapies. Advanced modalities such as SRS, HFSRT, brachytherapy, proton therapy, and IORT reduce but do not eliminate RN risk. Diagnosis remains challenging despite advanced MRI and PET techniques, with histopathology as the gold standard. Management includes corticosteroids, bevacizumab, surgery, LITT, and experimental therapies. Connectomics-based planning shows promise in minimizing RN by sparing critical brain networks. Conclusions: RN is a clinically significant and multifactorial complication of CNS radiotherapy. Precision treatment modalities and advanced imaging have improved prevention and detection, but diagnostic uncertainty and recurrence risk persist. Integration of connectomics into treatment planning may offer future promise of a reduction in RN-related morbidity by preserving structural and functional network integrity. Full article

Background/Objectives: Despite multimodal therapeutic concepts, treatment of recurrent malignant gliomas remains challenging. Stereotactic radiosurgery (SRS) may be a possible safe and effective non-invasive salvage treatment. In this study, we aim to investigate the SRS treatment outcomes using partly 18F-Fluorethylthyrosine (FET)-PET-imaging sequences for SRS treatment planning focusing on overall survival, event-free survival, and the incidence and factors influencing radiation necrosis (RN) occurrence. Additionally, we evaluated the potential application of AI-based tumor segmentation. Methods: We conducted a retrospective analysis of patients with recurrent malignant glioma treated with single-fraction or hypofractionated SRS at our institution. The outcomes assessed included local control, overall survival (OS), and local event-free survival (LEFS, defined as the interval until tumor recurrence or the onset of RN). We also performed a simulation analysis to assess the potential of AI-based tumor segmentation. Results: The study included 27 patients with a median age of 57 years and 41 lesions. The median OS post-SRS was 9.6 months and an LEFS of 5.2 months. Factors positively influencing OS and LEFS included the gross tumor volume (GTV) of the lesions before SRS therapy, presence of an IDH mutation, and lomustine treatment post-SRS. The incidence of RN post-SRS was 31.7%. RN was confirmed histopathologically in 15.4%, based on MRI in 46.2% and by FET-PET in 38.5% of lesions. In a simulation analysis, AI-based tumor segmentation reliably delineated all lesions, requiring only minimal manual adjustments to define target volumes. Conclusions: High-dose SRS is a feasible salvage treatment for small-volume recurrent high-grade gliomas, achieving local control and survival outcomes comparable to other re-irradiation strategies. IDH mutation, smaller tumor volume, and lomustine therapy were associated with improved survival. RN occurred frequently, particularly in periventricular lesions. AI-based tumor segmentation showed promise in well-defined satellite recurrences, but remains limited in cavity-adjacent lesions, underlining the need for expert review and ¹⁸FET-PET imaging. Full article

Background: Cervical cancer remains a major global health burden, and treatment failure due to radioresistance and secondary drug resistance severely limits clinical outcomes. Enhancer of zeste homolog 2 (EZH2) is a key epigenetic regulator implicated in tumor progression. This study aimed to determine whether EZH2-mediated PTEN silencing drives afatinib resistance via AKT activation in radiation-resistant cervical cancer cells. Methods: A radioresistant cervical cancer cell line (HeLaR) was established following cumulative irradiation (70 Gy). Cell viability, clonogenic survival, methylation-specific PCR (MSP), chromatin immunoprecipitation (ChIP), and Western blot analyses were conducted. EZH2 (Dznep; tazemetostat), PI3K, and AKT inhibitors were tested in combination with afatinib. A xenograft mouse model was used for in vivo validation. Results: HeLaR cells exhibited upregulation of EZH2 and H3K27me3, downregulation of PTEN, and sustained AKT activation. EZH2 inhibition restored PTEN expression, attenuated AKT phosphorylation, and re-sensitized cells to afatinib. MSP and ChIP confirmed EZH2-mediated PTEN promoter silencing. PI3K inhibition reproduced these effects, whereas ERK inhibition had minimal impact. In xenograft models, combined treatment with Dznep and afatinib significantly suppressed tumor growth compared to single agents. Conclusions: EZH2-driven PTEN suppression promotes AKT-dependent afatinib resistance in radiation-resistant cervical cancer. Targeting the EZH2–PTEN–AKT axis may provide a potential therapeutic approach to mitigate combined radioresistance and chemoresistance in recurrent cervical cancer, although further preclinical and clinical validation is required. Full article

The emergence of Candida auris as a disheartening fungal pathogen in healthcare settings has prompted urgent re-evaluation of containment and mitigation strategies. This review critically examines the biological persistence, environmental adaptability, and resistance to standard antifungal therapies of the pathogen, particularly regions with limited surveillance infrastructure. Based on regional experiences, such as those in Saudi Arabia and the Middle East in general, the study reveals systemic weaknesses in diagnosis, reporting, and environmental sanitation. Special consideration is paid to the combination of new disinfection technologies, including ultraviolet irradiation systems and hydrogen peroxide vaporisation, with institutional behaviour change strategies. This discussion shows the importance of synchronising technological development with frequent employee contributions and cross-functional planning. It also encourages the international standardisation of diagnostic platforms and the launch of real-time genomic surveillance to reveal evolutionary trends. Finally, the findings justify the shift towards proactive models of infection control that are founded on the resilience of systems and the agility of institutions. This paper is a synthesis of epidemiological patterns, decontamination strategies and behavioural knowledge to contribute to an emerging body of knowledge that can help to fortify healthcare settings against current fungal threats. Full article

Background: Pituicytomas are rare, low-grade gliomas arising from pituicytes in the posterior pituitary or infundibulum. Due to its rarity and nonspecific clinical and radiological characteristics, it is frequently misdiagnosed as pituitary adenomas or other sellar tumors. Aims: To present an overview of pituicytoma, including clinical presentation, radiological and histopathological characteristics, differential diagnosis and treatment strategies, illustrated by a case report. Methods: A literature review was conducted to contextualize our patient with a sellar tumor, and to highlight key diagnostic and therapeutic considerations. Results/Case report: A 12-year-old boy presented with visual disturbances. MRI revealed a well-defined contrast-enhancing sellar mass, and the patient underwent transsphenoidal surgery. The diagnosis was assumed to be a nonfunctioning pituitary adenoma (NFPA). Two years later a residual tumor was treated with proton irradiation. Six years after the radiotherapy, the patient had epistaxis. Imaging showed a tumor in the sphenoidale sinus, which was surgically resected. The tumor had histopathological features of pituicytoma and immunoreactivity for TTF-1 and S100. The tissue from the first operation was reviewed, showing more characteristics with pituicytoma than NFPA, leading to re-definition of the initial diagnosis. Follow-up has been without any signs of residual tumor. Conclusion: Our case and literature review emphasize the importance of considering pituicytoma in the differential diagnosis among sellar lesions. The diagnosis relies on a combination of preoperative imaging, intraoperative findings and histopathology. Pituitary surgery is the first-line treatment, and the outcome is generally good. Increased awareness of pituicytomas is necessary to improve preoperative diagnostic accuracy and guide appropriate management. Full article

Glioblastoma multiforme (GBM), the most aggressive primary brain tumor in adults, has a poor prognosis due to rapid recurrence and treatment resistance. This review examines the evolution of radiotherapy (RT) for GBM management, from whole-brain RT to modern techniques like intensity-modulated RT (IMRT) and volumetric modulated arc therapy (VMAT), guided by 2023 European Society for Radiotherapy and Oncology (ESTRO)-European Association of Neuro-Oncology (EANO) and 2025 American Society for Radiation Oncology (ASTRO) recommendations. The standard Stupp protocol (60 Gy/30 fractions with temozolomide [TMZ]) improves overall survival (OS) to 14.6 months, with greater benefits in O6-methylguanine-DNA methyltransferase (MGMT)-methylated tumors (21.7 months). Tumor Treating Fields (TTFields) extend median overall survival (mOS) to 31.6 months in MGMT-methylated patients and 20.9 months overall in supratentorial GBM (EF-14 trial). However, 80–90% of recurrences occur within 2 cm of the irradiated field due to tumor infiltration and radioresistance driven by epidermal growth factor receptor (EGFR) amplification, phosphatase and tensin homolog (PTEN) mutations, cyclin-dependent kinase inhibitor 2A/B (CDKN2A/B) deletions, tumor hypoxia, and tumor stem cells. Pseudoprogression, distinguished using Response Assessment in Neuro-Oncology (RANO) criteria and positron emission tomography (PET), complicates response evaluation. Targeted therapies (e.g., bevacizumab; PARP inhibitors) and immunotherapies (e.g., pembrolizumab; oncolytic viruses), alongside advanced imaging (multiparametric magnetic resonance imaging [MRI], amino acid PET), support personalized RT. Ongoing trials evaluating reirradiation, hypofractionation, stereotactic radiosurgery, neoadjuvant therapies, proton therapy (PT), boron neutron capture therapy (BNCT), and AI-driven planning aim to enhance efficacy for GBM IDH-wildtype, but phase III trials are needed to improve survival and quality of life. Full article

Background/Objectives: Recurrent meningiomas remain difficult to manage due to the absence of effective systemic therapies and comparatively high treatment failure rates, particularly in high-grade tumors. Stereotactic radiosurgery (SRS) offers a minimally-invasive and precise option, particularly for tumors in surgically complex locations. However, the risks associated with re-irradiation, and recent changes in the WHO classification of CNS tumors highlight the need for more personalized and strategic treatment approaches. This systematic review evaluates the safety, efficacy, and clinical considerations for use of SRS for recurrent meningiomas. Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature search was conducted using the PubMed, Scopus, and Web of Science databases for studies reporting outcomes of SRS in recurrent, pathologically confirmed intracranial meningiomas. Studies were excluded if they were commentaries, reviews, case reports with fewer than three cases, or had inaccessible full text. The quality and risk of bias of the included studies were assessed using the modified Newcastle-Ottawa Scale. Data on patient and tumor characteristics, SRS treatment parameters, clinical outcomes, adverse effects, and statistical analysis results were extracted. Results: Sixteen studies were included. For WHO Grade I tumors, 3- to 5-year progression-free survival (PFS) ranged from 85% to 100%. Grade II meningiomas demonstrated more variable outcomes, with 3-year PFS ranging from 23% to 100%. Grade III tumors had consistently poorer outcomes, with reported 1-year and 2-year PFS rates as low as 0% and 46%, respectively. SRS performed after surgery alone was associated with superior outcomes, with local control rates of 79% to 100% and 5-year PFS ranging from 40.4% to 91%. In contrast, tumors previously treated with radiotherapy, with or without surgery, showed substantially poorer outcomes, with 3- to 5-year PFS ranging from 26% to 41% and local control rates as low as 31%. Among patients with prior radiotherapy, outcomes were particularly poor in Grade II and III recurrent tumors. Toxicity rates ranged from 3.7% to 37%, and were generally higher for patients with prior radiation. Predictors of worse PFS included prior radiation, older age, and Grade III histology. Conclusions: SRS may represent a reasonable salvage option for carefully selected patients with recurrent meningioma, particularly following surgery alone. Outcomes were notably worse in high-grade recurrent meningiomas following prior radiotherapy, emphasizing the prognostic significance of both histological grade and treatment history. Notably, the lack of molecular and genetic data in most existing studies represents a key limitation in the current literature. Future prospective studies incorporating molecular profiling may improve risk stratification and support more personalized treatment strategies. Full article

Different polyurethanes (PURs) and silicone for potential use in particle accelerators and detectors have been characterized in the uncured state, after curing, and after exposure to ionizing irradiation in ambient air and in liquid helium. The viscosity evolution during processing was measured with a rheometer. Dynamic mechanical analysis (DMA) and Shore A hardness measurements were applied to detect irradiation-induced crosslinking and chain scission effects. Uniaxial tensile and flexural tests under ambient and cryogenic conditions have been performed to assess changes in mechanical strength, elongation at break, and elastic properties. The initial viscosity of 550 cP at 25 °C of the uncured PUR RE700-4 polyol and RE106 isocyanate system for protective encapsulation is sufficiently low for impregnation of small magnet coils, but the pot life of about 30 min is too short for impregnation of large magnet coils. The cured RE700-4 system has outstanding mechanical properties at 77 K (flexural strength, impact strength, and fracture toughness). When RE700-4 is exposed to ionizing radiation, chain scission and cross-linking occur at a similar rate. In the other casting systems, irradiation-induced changes are cross-linking dominated, as manifested by an increase of the rubbery shear modulus (G’_rubbery), the ambient temperature Young’s modulus (E_RT), and the Shore A hardness. Cross-linking rates are strongly reduced when irradiation occurs in liquid helium. The irradiation effect on mechanical properties can be strongly dependent on the testing temperature. The RT mechanical strength and strain at fracture of the cross-linking silicone is drastically decreased after 1.6 MGy, whereas its 77 K strain at fracture has almost doubled. In addition, 77 K elastic moduli are similar for all pure resins and only slightly affected by irradiation. Full article

Background: Small-cell lung cancer (SCLC) is a highly aggressive neuroendocrine malignancy characterized by rapid growth, early metastatic dissemination, and a dismal prognosis. For decades, treatment paradigms remained largely stagnant, particularly for extensive-stage disease (ES-SCLC). However, the last five years have witnessed a significant evolution in the therapeutic landscape. Methods: The information for this article was gathered by synthesizing data from several key sources. This article synthesizes the evidence supporting current standards of care for both limited-stage (LS-SCLC) and ES-SCLC, incorporating data from pivotal clinical trials, a network meta-analysis of first-line chemoimmunotherapy regimens, and a critical appraisal of international treatment guidelines, and a critical analysis of international treatment guidelines from prominent organizations like the National Comprehensive Cancer Network (NCCN) and the European Society for Medical Oncology (ESMO). This comprehensive approach allows for a robust and well-supported summary of the current therapeutic landscape. Results: For limited-stage SCLC (LS-SCLC), concurrent chemoradiotherapy (cCRT) remains the curative-intent standard, but its efficacy is now being augmented by consolidative immunotherapy, as demonstrated by the landmark ADRIATIC trial. The role of prophylactic cranial irradiation (PCI) in LS-SCLC is being re-evaluated in the era of high-sensitivity brain imaging and concerns over neurotoxicity. For ES-SCLC, the treatment paradigm has been fundamentally transformed by the integration of immune checkpoint inhibitors (ICIs) with platinum–etoposide chemotherapy, establishing a new standard of care that offers a modest but consistent survival benefit. Conclusions: The treatment of SCLC has been significantly advanced by the integration of immunotherapy, particularly for extensive-stage disease, which has established a new standard of care and improved patient outcomes. Looking to the future, the quest for predictive biomarkers and the development of novel therapeutic classes, such as Bi-specific T-cell Engagers (BiTEs) and antibody–drug conjugates, promise to build upon recent progress and offer new hope for improving the dismal prognosis associated with this disease. Full article

Space layout design has been recognized as a key technical challenge in achieving low-energy and low-carbon rural houses. Adjustment of room location can influence building energy performance and is subject to both meteorological and design parameters. To elucidate the impact of these parameters on the energy saving potential of room relocation (ESR), this study investigated rural houses in Northwest China using dynamic simulations to compare the relative energy saving rates (RES) associated with three types of single heated room location changes: from the west side to the middle (WM), from the east side to the middle (EM), and from the west side to the east side (WE). Simulations were conducted across different climate regions (Lhasa, Xi’an, Tuotuohe, and Altay) and design parameters, including exterior wall U-value, building orientation (BO), building height (BH), and window-to-wall ratio (WWR). Additionally, the maximum differences in energy consumption (MD) among six layouts with multiple heated rooms were assessed. The results demonstrated that ESR varied significantly with room relocation. The ranges of RES_WM, RES_EM, and RES_WE were −7.89% to 13.20%, −7.82% to 10.25%, and −2.29% to 3.36%, respectively. The MD values ranged from 2.42% to 15.01%. For single heated rooms, including direct normal irradiance (I_dn), the difference between east and west solar-air temperature (△T_sa), outdoor dry bulb temperature (T_e), exterior wall heat transfer coefficient (U), and WWR significantly influenced RES_WM and RES_EM. The ranking of the factor contributions was U > △T_sa > I_dn > T_e > WWR for RES_WM and U > I_dn > △T_sa > T_e > WWR for RES_EM. In the case of RES_WE, I_dn, △T_sa, T_e, exterior wall U value, and BO had significant effects, ranking I_dn > △T_sa > T_e > BO > U. For MD, the key influencing factors were I_dn, △T_sa, T_e, exterior wall U value, and WWR, which were ranked as I_dn > △T_sa > U > T_e > WWR. The effects of design parameters on ESR varied under different climatic conditions. In high-temperature regions, the exterior wall U-value had a stronger influence on the ESR of WE. In regions with larger |△T_sa|, BO exerted a more pronounced effect on the ESR of WE. In regions characterized by high temperatures and radiation, WWR and BH significantly influenced the ESR of WM and EM. Similarly, in these regions, WWR and BH exhibited a greater impact on MD. Finally, among the meteorological parameters, I_dn and △T_sa were significantly correlated with ESR (p < 0.01). These findings provide a valuable reference for the energy-efficient layout design of rural houses in Northwest China and cold regions and support the future development of intelligent and automated rural residential spatial layout design. Full article

The use of radiosensitizers is a beneficial approach in cancer radiotherapy treatment. However, the enhancement of radiation effects on cancer cells by radiosensitizers involves several different mechanisms, reflecting the chemical nature of the radiosensitizer. G-quadruplex (G4) DNA ligands have emerged in recent years as a potential new class of radiosensitizers binding to specific DNA sequences. Recently, we have shown that the Re(I) tricarbonyl complex PDF-Pz-Re and its pyrazolyl-diamine chelator PDF-Pz, carrying a N-methylated pyridostatin (PDF) derivative, act as G4 binders of various G4-forming DNA and RNA sequences. As described in this contribution, these features prompted us to evaluate PDF-Pz-Re and PDF-Pz as radiosensitizers of prostate cancer PC3 cells submitted to concomitant treatment with Co-60 radiation. The compound RHPS4 was also tested, as this G4 ligand was previously shown to exhibit strong radiosensitizing properties in other cancer cell lines. The assessment of the resulting radiobiological effects, namely through clonogenic cell survival, DNA damage, and ROS production assays, showed that PDF-Pz-Re and PDF-Pz were able to radiosensitize PC3 cells despite being less active than RHPS4. Our results corroborate that G4 DNA ligands are a class of compounds with potential interest as radiosensitizers, deserving further studies to optimize their radiosensitization activity and elucidate the mechanisms of action. Full article

Background and Purpose: Stratification based on specific image biomarkers applicable in clinical settings could help optimize treatment outcomes for recurrent non-small cell lung cancer patients. For this purpose, we aimed to determine the clinical impact of positive delta changes (any difference above zero > 0) between baseline [¹⁸F]FDG PET/CT metrics before the first treatment course and reirradiation. Material/Methods: Forty-seven patients who underwent thoracic reirradiation with curative intent at our institute between 2013 and 2021 met the inclusion criteria. All patients had histologically verified NSCLC, ECOG (Eastern Cooperative Oncology Group) ≤ 2, and underwent [¹⁸F]FDG PET/CT for initial staging and re-staging before primary radiotherapy and reirradiation, respectively. The time interval between radiation treatments was at least nine months. Quantitative metabolic volume and intensity parameters were measured before first irradiation and before reirradiation, and the difference above zero (>0; delta change) between them was statistically correlated to locoregional control (LRC), progression-free survival (PFS), and overall survival (OS). Results: Patients were followed for a median time of 33 months after reirradiation. The median OS was 21.8 months (95%-CI: 16.3–27.3), the median PFS was 12 months (95%-CI: 6.7–17.3), and the median LRC was 13 months (95%-CI: 9.0–17.0). Multivariate analysis revealed that the delta changes in SULpeak, SUVmax, and SULmax of the lymph nodes significantly impacted OS (SULpeak p = 0.017; SUVmax p = 0.006; SULmax p = 0.006), PFS (SULpeak p = 0.010; SUVmax p = 0.009; SULmax p = 0.009), and LRC (SULpeak p < 0.001; SUVmax p = 0.003; SULmax p = 0.003). Conclusions: Delta changes in SULpeak, SUVmax, and SULmax of the metastatic lymph nodes significantly impacted all clinical endpoints (OS, PFS and LRC) in recurrent NSCLC patients treated with reirradiation. Hence, these imaging biomarkers could be helpful with regard to patient selection in this challenging clinical situation. Full article