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Holubyev K, Gainey M, Bratengeier K, Polat B, Flentje M. Generation of prostate IMAT plans adaptable to the inter-fractional changes of patient geometry. Phys Med Biol 2014; 59:1947-62. [PMID: 24694541 DOI: 10.1088/0031-9155/59/8/1947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We present the results of 2-Step generation of adaptable IMAT plans for prostate carcinoma cases. The 2-Step IMAT plans show clinical and dosimetric equivalence to the reference SmartArc™-generated VMAT plans. The 2-Step plans are adapted to inter-fractional changes of prostate-rectum geometry using 2-Step adaptation rules for a cohort of ten adaptation cases. The adapted 2-Step IMAT plans show statistically significant improvement (Wilcoxon 1-tail p < 0.05) of target coverage and of rectum sparing when compared to isocenter relocated plans.
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Verburg FA, Sweeney R, Hänscheid H, Dießl S, Israel I, Löhr M, Vince GH, Flentje M, Reiners C, Samnick S. Patients with recurrent glioblastoma multiforme. Initial experience with p-[(131)I]iodo-L-phenylalanine and external beam radiation therapy. Nuklearmedizin 2013; 52:36-42. [PMID: 23303224 DOI: 10.3413/nukmed-0510-12-06] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 12/15/2012] [Indexed: 11/20/2022]
Abstract
AIM The objective of this study was to assess the feasibility, dosimetry, tolerability and efficacy of systemically administrated p-[(131)I]iodo-L-phenylalanine ((131)IPA) combined with hypo-fractionated external beam radiation therapy (EBRT) in patients with recurrent glioblastoma multiforme (GBM). PATIENTS, METHODS Five patients (2 women, 3 men, aged 27-69) with recurrent GBM and exhaustion of regular therapy options were included. All had a positive O-(2-[(18)F]Fluoroethyl)-L-tyrosine positron emission tomography (FET-PET) and pretherapeutic dosimetry was performed. Tumour targeting was verified by (131)IPA-SPECT up to six days after radiotracer administration. After (131)IPA therapy, patients were treated with hypo-fractionated EBRT in six fractions of 5 Gy (n = 4) or in eleven fractions of 2 Gy in one case. RESULTS Based on the individual dosimetry, the patients received a single intravenous administration of 2 to 7 GBq of (131)IPA, resulting in radiation absorbed doses to the blood of 0.80-1.47 Gy. The treatment was well tolerated; only minor complaints of nausea and vomiting that responded to ondansetron and pantoprazol were noticed in the first two patients. After preventive medication, the last three patients had no complaints during therapy. In none of the patients a decrease of leukocyte or thrombocyte counts below the baseline level or the lower normal limit was observed. Tumour doses from (131)IPA were low (≤ 1 Gy) and all patients died three to eight (median 5.5) months after therapy. CONCLUSION In this initial experience, treatment of GBM with (131)IPA in combination with EBRT was demonstrated to be safe and well tolerated, but less effective than suggested by the animal studies.
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Guckenberger M, Saur G, Wehner D, Sweeney RA, Thalheimer A, Germer CT, Flentje M. Comparison of preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer. Strahlenther Onkol 2012; 188:551-7. [PMID: 22638934 DOI: 10.1007/s00066-012-0131-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Accepted: 03/28/2012] [Indexed: 12/18/2022]
Abstract
BACKGROUND The purpose of this work was to perform a single institution comparison between preoperative short-course radiotherapy (SC-RT) and long-course radiochemotherapy (LC-RCHT) for locally advanced rectal cancer. METHODS A total of 225 patients with clinical stage UICC II-III rectal cancer were treated with SC-RT (29 Gy in 10 twice daily fractions followed by immediate surgery; n = 108) or LC-RCHT (54 Gy in 28 fractions with simultaneous 5-fluorouracil (5-FU) ± oxaliplatin chemotherapy followed by delayed surgery; n = 117). All patients in the LC-RCHT cohort and patients in the SC-RT with pathological UICC stage ≥ II received adjuvant chemotherapy. Before 2004, the standard of care was SC-RT with LC-RCHT reserved for patients where downstaging was considered as required for sphincter preservation or curative resection. In the later period, SC-RT was practiced only for patients unfit for radiochemotherapy. RESULTS Patients in the LC-RCHT cohort had a significantly higher proportion of cT4 tumors, clinical node positivity, and lower tumor location. The 5-year local control (LC) and overall survival (OS) were 91% and 66% without differences between the SC-RT and LC-RCHT groups. Acute toxicity was increased during LC-RCHT (grade ≥ II 1% vs. 33%) and there were no differences in postoperative complications. Severe late toxicity grade ≥ III was increased after SC-RT (12% vs. 3%). Of patients aged > 80 years, 7 of 7 patients and 4 of 9 patients received curative surgery after SC-RT and LC-RCHT, respectively. CONCLUSION Despite the fact that patients with worse prognostic factors were treated with LC-RCHT, there were no significant differences in LC and OS between the SC-RT and LC-RCHT group. Age > 80 years was identified as a significant risk factor for LC-RCHT and these patients could be treated preferably with SC-RT.
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Guckenberger M, Roesch J, Baier K, Sweeney R, Flentje M. OC-0045 GEOMETRIC AND DOSIMETRIC ACCURACY OF FRAME-LESS IMAGE-GUIDED RADIOSURGERY IN CLINICAL PRACTICE. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70384-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stingl L, Niewidok N, Müller N, Selle M, Djuzenova CS, Flentje M. Radiosensitizing effect of the novel Hsp90 inhibitor NVP-AUY922 in human tumour cell lines silenced for Hsp90α. Strahlenther Onkol 2012; 188:507-15. [PMID: 22441439 DOI: 10.1007/s00066-012-0080-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 01/11/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hsp90 inhibitors can enhance the tumour sensitivity to ionising radiation (IR). However, Hsp90 inhibition leads to the up-regulation of anti-apoptotic Hsp90 and Hsp70, which might diminish the radiosensitizing effects of the inhibitors. Therefore, inhibition of the up-regulation of Hsp90 by siRNA might be a promising strategy to enhance drug-mediated radiosensitization. MATERIALS AND METHODS The expression of Hsp90α was silenced in A549 and GaMG tumour cell lines by siRNA treatment. Pre-silenced for Hsp90α cells were treated with NVP-AUY922, a novel Hsp90 inhibitor, for 24 h and then irradiated. Radiation response was determined by colony-forming ability. The expression of several marker proteins was analysed by Western blot. DNA damage and repair were assessed by histone γH2AX measurements. RESULTS We found that transfection with siRNA against Hsp90α reduced Hsp90α at mRNA and protein levels. Pre-silencing of Hsp90α reduced NVP-AUY922-mediated up-regulation of Hsp90α but it did not increase drug-mediated radiosensitization in both tumour cell lines. As revealed by Western blot, pre-silencing of Hsp90α followed by NVP-AUY922 did not change the expression of Hsp90 client proteins (Akt, Raf-1, Cdk1 and Cdk4) compared with drug treatment alone, suggesting unchanged chaperone function in transfected cells. CONCLUSION Pre-silencing of Hsp90α followed by Hsp90 inhibition did not enhance the radiosensitizing effect of NVP-AUY922 in both tested tumour cell lines. Future work will be done on stable transfection with shRNA against Hsp90α or simultaneous silencing of both Hsp90 isoforms, Hsp90α and Hsp90β, in order to optimize tumour cell killing.
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Polat B, Kreissl M, Haenscheid H, Sweeney R, Reiners C, Buck A, Flentje M. External Beam Radiotherapy in Combination with Peptide Receptor Radionuclide Therapy (PRRT) in Irresectable or Recurrent Meningioma. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Goeckenjan G, Sitter H, Thomas M, Branscheid D, Flentje M, Griesinger F, Niederle N, Stuschke M, Blum T, Deppermann KM, Ficker J, Freitag L, Lübbe A, Reinhold T, Späth-Schwalbe E, Ukena D, Wickert M, Wolf M, Andreas S, Auberger T, Baum R, Baysal B, Beuth J, Bickeböller H, Böcking A, Bohle R, Brüske I, Burghuber O, Dickgreber N, Diederich S, Dienemann H, Eberhardt W, Eggeling S, Fink T, Fischer B, Franke M, Friedel G, Gauler T, Gütz S, Hautmann H, Hellmann A, Hellwig D, Herth F, Heußel C, Hilbe W, Hoffmeyer F, Horneber M, Huber R, Hübner J, Kauczor HU, Kirchbacher K, Kirsten D, Kraus T, Lang S, Martens U, Mohn-Staudner A, Müller KM, Müller-Nordhorn J, Nowak D, Ochmann U, Passlick B, Petersen I, Pirker R, Pokrajac B, Reck M, Riha S, Rübe C, Schmittel A, Schönfeld N, Schütte W, Serke M, Stamatis G, Steingräber M, Steins M, Stoelben E, Swoboda L, Teschler H, Tessen H, Weber M, Werner A, Wichmann HE, Irlinger Wimmer E, Witt C, Worth H. Prävention, Diagnostik, Therapie und Nachsorge des Lungenkarzinoms. Pneumologie 2011; 65:e51-75. [DOI: 10.1055/s-0030-1256562] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Gainey M, Bratengeier K, Flentje M. 416 poster COMPUTERISATION OF 2 STEP IMAT/IMRT SEGMENT GENERATION. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70538-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Guckenberger M, Richter A, Wilbert J, Flentje M, Partridge M. 95 oral ADAPTATION OF RADIOTHERAPY TO A SHRINKING MACROSCOPIC TUMOR IN ADVANCED STAGE NSCLC DOES NOT UNDERDOSE THE MICROSCOPIC DISEASE AND HAS THE POTENTIAL TO INCREASE TUMOR CONTROL PROBABILITY. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70218-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Moehler M, Al-Batran SE, Andus T, Anthuber M, Arends J, Arnold D, Aust D, Baier P, Baretton G, Bernhardt J, Boeing H, Böhle E, Bokemeyer C, Bornschein J, Budach W, Burmester E, Caca K, Diemer WA, Dietrich CF, Ebert M, Eickhoff A, Ell C, Fahlke J, Feussner H, Fietkau R, Fischbach W, Fleig W, Flentje M, Gabbert HE, Galle PR, Geissler M, Gockel I, Graeven U, Grenacher L, Gross S, Hartmann JT, Heike M, Heinemann V, Herbst B, Herrmann T, Höcht S, Hofheinz RD, Höfler H, Höhler T, Hölscher AH, Horneber M, Hübner J, Izbicki JR, Jakobs R, Jenssen C, Kanzler S, Keller M, Kiesslich R, Klautke G, Körber J, Krause BJ, Kuhn C, Kullmann F, Lang H, Link H, Lordick F, Ludwig K, Lutz M, Mahlberg R, Malfertheiner P, Merkel S, Messmann H, Meyer HJ, Mönig S, Piso P, Pistorius S, Porschen R, Rabenstein T, Reichardt P, Ridwelski K, Röcken C, Roetzer I, Rohr P, Schepp W, Schlag PM, Schmid RM, Schmidberger H, Schmiegel WH, Schmoll HJ, Schuch G, Schuhmacher C, Schütte K, Schwenk W, Selgrad M, Sendler A, Seraphin J, Seufferlein T, Stahl M, Stein H, Stoll C, Stuschke M, Tannapfel A, Tholen R, Thuss-Patience P, Treml K, Vanhoefer U, Vieth M, Vogelsang H, Wagner D, Wedding U, Weimann A, Wilke H, Wittekind C. [German S3-guideline "Diagnosis and treatment of esophagogastric cancer"]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2011; 49:461-531. [PMID: 21476183 DOI: 10.1055/s-0031-1273201] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Goeckenjan G, Sitter H, Thomas M, Branscheid D, Flentje M, Griesinger F, Niederle N, Stuschke M, Blum T, Deppermann KM, Ficker J, Freitag L, Lübbe A, Reinhold T, Späth-Schwalbe E, Ukena D, Wickert M, Wolf M, Andreas S, Auberger T, Baum R, Baysal B, Beuth J, Bickeböller H, Böcking A, Bohle R, Brüske I, Burghuber O, Dickgreber N, Diederich S, Dienemann H, Eberhardt W, Eggeling S, Fink T, Fischer B, Franke M, Friedel G, Gauler T, Gütz S, Hautmann H, Hellmann A, Hellwig D, Herth F, Heußel C, Hilbe W, Hoffmeyer F, Horneber M, Huber R, Hübner J, Kauczor HU, Kirchbacher K, Kirsten D, Kraus T, Lang S, Martens U, Mohn-Staudner A, Müller KM, Müller-Nordhorn J, Nowak D, Ochmann U, Passlick B, Petersen I, Pirker R, Pokrajac B, Reck M, Riha S, Rübe C, Schmittel A, Schönfeld N, Schütte W, Serke M, Stamatis G, Steingräber M, Steins M, Stoelben E, Swoboda L, Teschler H, Tessen H, Weber M, Werner A, Wichmann HE, Irlinger Wimmer E, Witt C, Worth H. Prevention, Diagnosis, Therapy, and Follow-up of Lung Cancer. Pneumologie 2010; 65:39-59. [DOI: 10.1055/s-0030-1255961] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Polat B, Said H, Katzer A, Guckenberger M, Mlynski R, Flentje M, Vordermark D. Osteopontin Plasma Levels in Head and Neck Cancer Patients During Radiotherapy. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Dietz A, Flentje M, Hagen R, Kortmann RD, Hildebrand G, Hoppe F, Schwienhorst I, Keilholz U. Docetaxel, cisplatin (TP), and radiation with or without cetuximab in advanced larynx carcinoma (DeLOS II trial). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps265] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kuhnt T, Sandner A, Wendt T, Engenhart-Cabillic R, Lammering G, Flentje M, Grabenbauer G, Schreiber A, Pirnasch A, Dunst J. Phase I trial of dose-escalated cisplatin with concomitant cetuximab and hyperfractionated-accelerated radiotherapy in locally advanced squamous cell carcinoma of the head and neck. Ann Oncol 2010; 21:2284-2289. [PMID: 20427347 DOI: 10.1093/annonc/mdq216] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cetuximab is active in the treatment of squamous cell carcinoma of the head and neck (SCCHN), enhancing both radiotherapy and chemotherapy effects. This phase I study was designed to investigate the safety and tolerability of combining weekly cisplatin treatment with cetuximab and hyperfractionated-accelerated radiotherapy (HART) for locally advanced SCCHN. PATIENTS AND METHODS Patients with unresectable stage III or IVA/B SCCHN were treated with cetuximab, 400 mg/m² initial dose on day -7 of HART, followed by 250 mg/m² weekly during the administration of HART, which started with 2.0 Gy/day (5 days/week) for 3 weeks followed by 1.4 Gy/twice-daily (Monday to Friday) for another 3 weeks, resulting in a total dose of 70.6 Gy. Cisplatin was administered weekly starting on the first day of radiotherapy until week 6. Cisplatin was dose escalated of four dose levels from 20 to 40 mg/m² using a classical 3 + 3 dose escalation algorithm. RESULTS Eighteen patients were enrolled. Sixteen patients were eligible for toxicity, and 15 for response. No maximum tolerated dose was reached for cisplatin. One of six patients of dose level 4 had grade 4 neutropenia. This patient died 1 week after the end of the study treatment. The most common types of grade 3+ adverse events were mucositis (9 of 16 patients), in-field dermatitis (6 of 16 patients) and neutropenia (4 of 16 patients). Cetuximab-related hypersensitivity was observed in 1 out of 18 patients. Six weeks after the end of the study treatment, 5 complete responses, 8 partial responses and 1 progressive disease (at distant sites) were documented in a total of 15 patients (objective response rate 87%). CONCLUSIONS The combination of cisplatin with cetuximab and HART is active, well tolerated and merits additional investigation. The recommended weekly dose of cisplatin for phase II studies is 40 mg/m².
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Goeckenjan G, Sitter H, Thomas M, Branscheid D, Flentje M, Griesinger F, Niederle N, Stuschke M, Blum T, Deppermann KM, Ficker JH, Freitag L, Lübbe AS, Reinhold T, Späth-Schwalbe E, Ukena D, Wickert M, Wolf M, Andreas S, Auberger T, Baum RP, Baysal B, Beuth J, Bickeböller H, Böcking A, Bohle RM, Brüske I, Burghuber O, Dickgreber N, Diederich S, Dienemann H, Eberhardt W, Eggeling S, Fink T, Fischer B, Franke M, Friedel G, Gauler T, Gütz S, Hautmann H, Hellmann A, Hellwig D, Herth F, Heussel CP, Hilbe W, Hoffmeyer F, Horneber M, Huber RM, Hübner J, Kauczor HU, Kirchbacher K, Kirsten D, Kraus T, Lang SM, Martens U, Mohn-Staudner A, Müller KM, Müller-Nordhorn J, Nowak D, Ochmann U, Passlick B, Petersen I, Pirker R, Pokrajac B, Reck M, Riha S, Rübe C, Schmittel A, Schönfeld N, Schütte W, Serke M, Stamatis G, Steingräber M, Steins M, Stoelben E, Swoboda L, Teschler H, Tessen HW, Weber M, Werner A, Wichmann HE, Irlinger Wimmer E, Witt C, Worth H. [Prevention, diagnosis, therapy, and follow-up of lung cancer]. Pneumologie 2010; 64 Suppl 2:e1-164. [PMID: 20217630 DOI: 10.1055/s-0029-1243837] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Guckenberger M, Richter A, Wilbert J, Krieger T, Baier K, Flentje M. How Much Lung Sparing is Achievable by Adaptive Radiotherapy in Treatment of Advanced-stage Non–small-cell Lung Cancer? Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Guckenberger M, Richter A, Krieger T, Wilbert J, Baier K, Flentje M. IS ONE SINGLE ARC SUFFICIENT IN VOLUMETRIC MODULATED ARC THERAPY FOR COMPLEX SHAPED TARGET VOLUMES? Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)73098-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Gainey M, Bratengeier K, Polat B, Meyer J, Flentje M. MO-D-BRB-09: IMRT Ad-Hoc Adaption - Initial Results for Prostate: A Retrospective Planning Study. Med Phys 2009. [DOI: 10.1118/1.3182219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Wilkowski R, Boeck S, Ostermaier S, Sauer R, Herbst M, Fietkau R, Flentje M, Bruns CJ, Rau HG, Heinemann V. Final analysis of a multicenter, randomized phase II trial comparing three different chemoradiotherapy regimens in the treatment of patients with locally advanced, nonmetastatic pancreatic cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4610 Background: To date, no standard treatment approach for patients (pts) with non-resectable, locally advanced pancreatic cancer (PC) is defined. Methods: Within a prospective phase II trial treatment-naive pts with locally advanced PC and adequate organ function were randomly assigned to three different CRT regimens; all pts received a conventionally fractionated radiotherapy of 50 Gy (with a daily dose of 2.0 Gy) and were randomized to either concurrent 5-FU as a 24h-infusion (350 mg/m2/d on each day of radiotherapy, RT-5FU arm), concurrent low-dose gemcitabine 300 mg/m2 and cisplatin 30 mg/m2 on days 1, 8, 22, and 29 (RT-GC arm), or the same concurrent treatment followed by a sequential chemotherapy with full- dose gemcitabine (1000 mg/m2) and cisplatin (50 mg/m2) every two weeks (RT-GC+GC arm). Treatment duration in the RT- GC+GC arm was upon disease progression or unacceptable toxicity. The primary study endpoint was the overall survival (OS) rate after 9 months (mo); secondary endpoints included response rate (WHO criteria), progression-free survival (PFS), resectability and toxicity. Results: Ninety-five patients (median age 64 years, 54% male, 50% KPS 90–100%) were recruited from 12 German centers. Seventy patients were evaluable for objective response: the intent-to-treat response rate (CR+PR) was 19% in the RT-5FU arm, 22% in the RT-GC arm and 13% in the RT-GC+GC arm, respectively. Overall, 18 pts (19%) underwent surgical resection after initial CRT (R0 in 8 pts). After a median follow-up of 8.6 mo, median PFS was estimated with 4 mo (RT-5FU), 5.6 mo (RT-GC) and 6 mo (RT- GC+GC), respectively (p=0.21). The corresponding median OS times were 9.6 mo, 9.3 mo and 7.3 mo (p=0.61). Hematological grade 3/4 toxicities were higher in the two gemcitabine/cisplatin-containing arms, but no grade 3/4 febrile neutopenia was observed. Regarding non-hematological toxicity, nausea/vomiting were more frequently in the RT-GC and RT-GC+GC arm, whereas diarrhea was more frequent in the RT-5FU arm. Conclusions: Based on these data, gemcitabine/cisplatin-based CRT does not achieve a higher clinical efficacy compared to RT-5FU, and is associated with increased hematological toxicity. [Table: see text]
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Kuhnt T, Sandner A, Wendt TG, Engenhardt-Cabillic R, Lammering G, Flentje M, Grabenbauer GG, Pirnasch A, Baumann M, Dunst J. Concomitant hyperfractionated accelerated radiotherapy (HART) with cisplatin and concurrent cetuximab for locoregionally advanced squamous cell head and neck cancer: a phase I dose escalation trial. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.6029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Dietz A, Keilholz U, Werner J, Hagen R, Flentje M, Iro H. Stellenwert der Induktionstherapie bei Kopf-Hals-Tumoren. Laryngorhinootologie 2008; 87:237-43; discussion 244. [DOI: 10.1055/s-2007-995588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Guckenberger M, Krieger T, Wilbert J, Baier K, Richter A, Polat B, Flentje M. Four Dimensional Target Volume Generation in Pulmonary Stereotactic Body Radiotherapy. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.345] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kortmann RD, Bongartz R, Dieckmann K, Dunst J, Flentje M, Gademann G, Christiansen H, Kamprad FH, Karstens JH, Pape H, Rühl U, Schmidt BF, Willich N, Schulz-Ertner D, Schwarz R, Timmermann B, Pohl F, Klingebiel T, Jürgens H, Rübe C. [Requirements and performance profile of the Paediatric Radiation Oncology Working Group (APRO): evaluation of the present situation and description of future developments]. KLINISCHE PADIATRIE 2007; 219:166-72. [PMID: 17525911 DOI: 10.1055/s-2007-973855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Radiation therapy is an integral component in the management of childhood malignancies and undergoes a continuous process of optimization within the prospective trials of the GPOH. At present there are approximately 20 active protocols, some specifying radio-oncological study questions, in which about 500 to 600 children annually are given radiotherapy. MATERIALS/METHODS The Pediatric Radiation Oncology Working Group (APRO) of the German Society for Radiation Oncology (DEGRO) represents the organizational link between GPOH and DEGRO. Their activities range from phrasing guidelines of radio-oncological therapy, through writing a protocol for a prospective study on radiation-induced late effects (RISK--in co-operation with GPOH, 695 patients registered so far) and organizing meetings for information transfer, to implementing radio-oncology within the prospective studies of the GPOH by establishing study chairs for radio-oncology when radio-oncological questions are a primary focus and/or to function as a reference institution for quality assurance. These activities also include individual case consultations outside the study proper. Twice annually the members of the APRO meet for an update on current knowledge and future directions where a representative of the GPOH is invited to contribute special aspects of pediatric oncology. CONCLUSIONS In the future, modern technology (intensity modulated radiotherapy, proton therapy, inclusion of imaging in treatment planning) will be part of disease management in pediatric oncology. A working group for modern radiotherapy technology was established to enhance this development. Prospective studies of the GPOH with primary or secondary radio-oncological questions require the implementation of corresponding tasks (documentation, monitoring, etc.) in order to meet future demands on clinical trials and to achieve the aims of the protocol. Consequently adequate financial support is indispensable.
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Pfreundner L, Relic A, Guckenberger M, Voelter C, Schwab F, Hoppe F, Hagen R, Flentje M. Organ preservation by induction chemotherapy and CT-based 3D radiotherapy in patients with advanced laryn geal and hypopharyngeal carcinomas. Radiother Oncol 2007. [DOI: 10.1016/s0167-8140(07)80185-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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