Santiago de Compostela. Pilgerarchitektur und bildliche Repräsentation in neuer Perspektive

Die Kathedrale von Santiago de Compostela, als Ziel und Höhepunkt der Pilgerwege zum Jakobsgrab, darf heute mehr denn je Aufmerksamkeit beanspruchen, nicht nur als Ziel des Jakobsweges, sondern vor allem als architektonische und kulturgeschichtliche Quelle. Das mehrjährige Forschungsprojekt von Bernd Nicolai, Universität Bern und Klaus Rheidt, Universität Cottbus, 'Die Kathedrale von Santiago de Compostela - Gestalt, Funktion und Programm', das den Bau und seinen architektur- und kunstgeschichtlichen Kontext von Grund auf neu untersucht, legt hier eine Zwischenbilanz vor. Der Band präsentiert erstmalig Ergebnisse zu Bauverlauf und Ausstattung auf der Basis einer neuen Bauforschung, Baugeschichte und Quellenanalyse und konfrontiert sie mit aktuellen internationalen Forschungen in Spanien, den USA, der Schweiz, Deutschland, England und Frankreich zum Themenbereich der Pilgerstraßenarchitektur und -skulptur.

Dose-painting intensity-modulated proton therapy for intermediate- and high-risk meningioma.

BACKGROUND Newly diagnosed WHO grade II-III or any WHO grade recurrent meningioma exhibit an aggressive behavior and thus are considered as high- or intermediate risk tumors. Given the unsatisfactory rates of disease control and survival after primary or adjuvant radiation therapy, optimization of treatment strategies is needed. We investigated the potential of dose-painting intensity-modulated proton beam-therapy (IMPT) for intermediate- and high-risk meningioma. MATERIAL AND METHODS Imaging data from five patients undergoing proton beam-therapy were used. The dose-painting target was defined using [68]Ga-[1,4,7,10-tetraazacyclododecane tetraacetic acid]- d-Phe(1),Tyr(3)-octreotate ([68]Ga-DOTATATE)-positron emission tomography (PET) in target delineation. IMPT and photon intensity-modulated radiation therapy (IMRT) treatment plans were generated for each patient using an in-house developed treatment planning system (TPS) supporting spot-scanning technology and a commercial TPS, respectively. Doses of 66 Gy (2.2 Gy/fraction) and 54 Gy (1.8 Gy/fraction) were prescribed to the PET-based planning target volume (PTVPET) and the union of PET- and anatomical imaging-based PTV, respectively, in 30 fractions, using simultaneous integrated boost. RESULTS Dose coverage of the PTVsPET was equally good or slightly better in IMPT plans: dose inhomogeneity was 10 ± 3% in the IMPT plans vs. 13 ± 1% in the IMRT plans (p = 0.33). The brain Dmean and brainstem D50 were small in the IMPT plans: 26.5 ± 1.5 Gy(RBE) and 0.002 ± 0.0 Gy(RBE), respectively, vs. 29.5 ± 1.5 Gy (p = 0.001) and 7.5 ± 11.1 Gy (p = 0.02) for the IMRT plans, respectively. The doses delivered to the optic structures were also decreased with IMPT. CONCLUSIONS Dose-painting IMPT is technically feasible using currently available planning tools and resulted in dose conformity of the dose-painted target comparable to IMRT with a significant reduction of radiation dose delivered to the brain, brainstem and optic apparatus. Dose escalation with IMPT may improve tumor control and decrease radiation-induced toxicity.