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Habart D, Koza A, Leontovyc I, Kosinova L, Berkova Z, Kriz J, Zacharovova K, Brinkhof B, Cornelissen DJ, Magrane N, Bittenglova K, Capek M, Valecka J, Habartova A, Saudek F. IsletSwipe, a mobile platform for expert opinion exchange on islet graft images. Islets 2023; 15:2189873. [PMID: 36987915 PMCID: PMC10064927 DOI: 10.1080/19382014.2023.2189873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
We previously developed a deep learning-based web service (IsletNet) for an automated counting of isolated pancreatic islets. The neural network training is limited by the absent consensus on the ground truth annotations. Here, we present a platform (IsletSwipe) for an exchange of graphical opinions among experts to facilitate the consensus formation. The platform consists of a web interface and a mobile application. In a small pilot study, we demonstrate the functionalities and the use case scenarios of the platform. Nine experts from three centers validated the drawing tools, tested precision and consistency of the expert contour drawing, and evaluated user experience. Eight experts from two centers proceeded to evaluate additional images to demonstrate the following two use case scenarios. The Validation scenario involves an automated selection of images and islets for the expert scrutiny. It is scalable (more experts, images, and islets may readily be added) and can be applied to independent validation of islet contours from various sources. The Inquiry scenario serves the ground truth generating expert in seeking assistance from peers to achieve consensus on challenging cases during the preparation for IsletNet training. This scenario is limited to a small number of manually selected images and islets. The experts gained an opportunity to influence IsletNet training and to compare other experts' opinions with their own. The ground truth-generating expert obtained feedback for future IsletNet training. IsletSwipe is a suitable tool for the consensus finding. Experts from additional centers are welcome to participate.
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Affiliation(s)
- David Habart
- Laboratory of Pancreatic Islets, Center of Experimental Medicine, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
- CONTACT David Habart Laboratory of pancreatic islets, Center of Experimental Medicine, Institute for Clinical and Experimental Medicine, Videnska 1958/9, Prague 4, 140 21, Czech Republic
| | - Adam Koza
- Dino School & Novy PORG, Prague, Czech Republic
| | - Ivan Leontovyc
- Laboratory of Pancreatic Islets, Center of Experimental Medicine, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Lucie Kosinova
- Laboratory of Pancreatic Islets, Center of Experimental Medicine, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Zuzana Berkova
- Laboratory of Pancreatic Islets, Center of Experimental Medicine, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Jan Kriz
- Diabetes Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Klara Zacharovova
- Laboratory of Pancreatic Islets, Center of Experimental Medicine, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Bas Brinkhof
- Department of Internal Medicine, Leiden University Medical Center (LUMC), Leiden, Netheralnds
| | - Dirk-Jan Cornelissen
- Department of Internal Medicine, Leiden University Medical Center (LUMC), Leiden, Netheralnds
| | - Nicholas Magrane
- Nuffield department of surgical sciences, Oxford Consortium for Islet transplantation, Oxford, UK
| | - Katerina Bittenglova
- Diabetes Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Martin Capek
- Light Microscopy Laboratory, Institute of Molecular Genetics of the Czech Academy of Sciences, Prague, Czech Republic
- Laboratory of Biomathematics, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Jan Valecka
- Laboratory of Biomathematics, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Alena Habartova
- Redox Photochemistry Lab, Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences, Prague, Czech Republic
| | - František Saudek
- Diabetes Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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Oertel M, Hering D, Kittel C, Nacke N, Kröger K, Kriz J, Fuchs M, Baues C, Vordermark D, Engenhart-Cabillic R, Herfarth KK, Lukas P, Schmidberger H, Marnitz-Schulze S, Borchmann P, Engert A, Haverkamp U, Eich HTT. Quality Analysis of Radiation Therapy for Hodgkin Lymphoma in the HD 16/17 Trials: A Final Report By the Reference Radiation Oncology Panel of the German Hodgkin Study Group. Int J Radiat Oncol Biol Phys 2023; 117:S62. [PMID: 37784540 DOI: 10.1016/j.ijrobp.2023.06.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The HD 16 and 17 trials by the German Hodgkin Study Group (GHSG) have evaluated the use of consolidative radiotherapy (RT) in early-favorable and -unfavorable stage Hodgkin lymphoma (HL), respectively (1, 2). Quality of RT planning and execution is pivotal for treatment outcome in HL with protocol violations jeopardizing prognosis (3). Consequently, the present work aims at a decisive analysis of quality and dosimetry in the modern era. MATERIALS/METHODS Random samples of 100 involved-field RT (IFRT) plans in HD16 and 176 plans in HD17 (134 involved-node RT (INRT) and 42 IFRT) were selected for analysis. Evaluation was performed systematically by the reference radiation oncology panel using pre-chemotherapy imaging, recommendation by the reference radiation oncology and RT planning imaging and graded as "correct", "minor" or "major deviation", respectively. RT doses to the target volume and organs at risks (OAR) were analyzed using dose-volume histograms. RESULTS Median RT doses were 20 Gy (19.8 Gy-21.6 Gy) in HD16 and 30 Gy in HD17 (IFRT: 18-30.6 Gy, INRT: 14 Gy-40 Gy). Overall, 84.0%, 69.0%, and 76.1% of RT series in HD16, the IFRT-group of HD17 and the INRT-group of HD17, respectively, were planned correctly. The main reason for major deviation was an insufficient coverage of an involved region (11 %-14.3 %). There was no significant difference in quality between IFRT and INRT in HD17 (p = 0.418 for any deviations; p = 0.466 for major deviations). In comparison to previous GHSG studies in the respective stages, a significant increase in correct RT-series (p<0.001) and decrease in major deviations (p<0.001) occurred. However, doses to OAR varied individually with median values of 4.3 Gy (0.2 Gy-9.2 Gy), 4.7 Gy (0.2 Gy-15.2 Gy) and 3.8 Gy (0.0 Gy-16.0 Gy) for mean doses to the right lung, left lung and heart in HD16, respectively. Correspondingly, values were 9.8 Gy (0.3 Gy-20.0 Gy), 10.5 Gy (0.2 Gy-26.5 Gy) and 13.1 Gy (0.5 Gy-30.4 Gy) for mean doses to the right lung, left lung and heart in HD17, respectively. The size of the planning target volume decreased significantly with INRT compared to IFRT (median values: 1163.1 ml vs. 1464.3 ml; p = 0.043). However, only some OAR-parameters (V25 of the right and left lung, respectively, thyroid and spinal cord) showed significant differences between INRT and IFRT in HD17. The use of intensity-modulated techniques in HD 17 resulted in an increase in V5 and V10 of the lungs with a concomitant decrease in V20-V30. CONCLUSION Quality of RT in the planning and treatment of HL has improved significantly with the latest GHSG study generation. Future analyses will focus on a further individualization of treatment fields. LITERATURE
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Affiliation(s)
- M Oertel
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - D Hering
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - C Kittel
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - N Nacke
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - K Kröger
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - J Kriz
- Department of Radiation Oncology, Alexianer Clemenshospital Muenster, Muenster, Germany
| | - M Fuchs
- German Hodgkin Study Group (GHSG), Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - C Baues
- Department of Radiation Oncology and CyberKnife Center, University Hospital of Cologne, Cologne, Germany
| | - D Vordermark
- Department of Radiation Oncology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - R Engenhart-Cabillic
- Department of Radiotherapy and Radiation Oncology, University Hospital Giessen-Marburg, Marburg, Germany
| | - K K Herfarth
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - P Lukas
- Department of Radiooncology, Medical University Innsbruck, Innsbruck, Austria
| | - H Schmidberger
- Department of Radiotherapy and Radiation Oncology, University Hospital Mainz, Mainz, Germany
| | - S Marnitz-Schulze
- Department of Radiation Oncology and CyberKnife Center, University Hospital of Cologne, Cologne, Germany
| | - P Borchmann
- German Hodgkin Study Group (GHSG), Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - A Engert
- German Hodgkin Study Group (GHSG), Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - U Haverkamp
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - H T T Eich
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
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3
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Oertel M, Hering D, Nacke N, Kittel C, Kröger K, Kriz J, Fuchs M, Baues C, Vordermark D, Engenhart-Cabillic R, Herfarth K, Lukas P, Schmidberger H, Marnitz S, Borchmann P, Engert A, Haverkamp U, Eich HT. Radiation Therapy in the German Hodgkin Study Group HD 16 and HD 17 Trials: Quality Assurance and Dosimetric Analysis for Hodgkin Lymphoma in the Modern Era. Adv Radiat Oncol 2023; 8:101169. [PMID: 36896214 PMCID: PMC9991533 DOI: 10.1016/j.adro.2022.101169] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
Purpose Radiation therapy (RT) is an integral part of treatment concepts for early-stage Hodgkin lymphoma. This analysis reports on RT quality in the recent HD16 and 17 trials of the German Hodgkin Study Group (GHSG). Methods and Materials All RT plans of involved-node radiation therapy (INRT) in HD 17 were requested for analysis, along with 100 and 50 involved-field radiation therapy (IFRT) plans in HD 16 and 17, respectively. A structured assessment regarding field design and protocol adherence was performed by the reference radiation oncology panel of the GHSG. Results Overall, 100 (HD 16) and 176 (HD 17) patients were eligible for analysis. In HD 16, 84% of RT series were evaluated as correct, with significant improvement compared with the predecessor studies (P < .001). In HD 17, 76.1% of INRT cases revealed a correct RT design compared with 69.0% of IFRT-cases, which was superior to previous studies (P < .001). Comparing INRT and IFRT, we found no significant differences in the percentage of any deviation (P = .418) or major deviations (P = .466). Regarding dosimetry, INRT was accompanied by an improvement in thyroid doses. Comparing different RT techniques, we found that intensity-modulated RT showed a reduction of high doses in the lung at the expense of an increased low-dose exposure in HD 17. Conclusions The latest study generation of the GHSG demonstrates an improved quality in RT. A modern INRT design could be established without deterioration in quality. On a conceptual level, an individual consideration of the appropriate RT technique has to be performed.
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Affiliation(s)
- Michael Oertel
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Dominik Hering
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Nina Nacke
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Christopher Kittel
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Kai Kröger
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Jan Kriz
- Department of Radiation Oncology, Alexianer Clemenshospital Muenster, Muenster, Germany
| | - Michael Fuchs
- Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne, Düsseldorf, University Hospital of Cologne, Cologne, Germany
| | - Christian Baues
- Department of Radiation Oncology and Cyberknife Center, University Hospital of Cologne, Cologne, Germany
| | - Dirk Vordermark
- Department of Radiation Oncology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Rita Engenhart-Cabillic
- Department of Radiotherapy and Radiation Oncology, University Hospital Giessen-Marburg, Marburg, Germany
| | - Klaus Herfarth
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Lukas
- Department of Radiooncology, Medical University Innsbruck, Innsbruck, Austria
| | - Heinz Schmidberger
- Department of Radiotherapy and Radiation Oncology, University Hospital Mainz, Mainz, Germany
| | - Simone Marnitz
- Department of Radiation Oncology and Cyberknife Center, University Hospital of Cologne, Cologne, Germany
| | - Peter Borchmann
- Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne, Düsseldorf, University Hospital of Cologne, Cologne, Germany
| | - Andreas Engert
- Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne, Düsseldorf, University Hospital of Cologne, Cologne, Germany
| | - Uwe Haverkamp
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Hans Theodor Eich
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
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Oertel M, Hering D, Baues C, Kittel C, Fuchs M, Kriz J, Kröger K, Vordermark D, Herfarth K, Engenhart-Cabillic R, Lukas P, Haverkamp U, Borchmann P, Eich HT. Radiation doses to mediastinal organs at risk in early-stage unfavorable Hodgkin lymphoma- a risk stratified analysis of the GHSG HD17 trial. Front Oncol 2023; 13:1183906. [PMID: 37213291 PMCID: PMC10196378 DOI: 10.3389/fonc.2023.1183906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/14/2023] [Indexed: 05/23/2023] Open
Abstract
Introduction The German Hodgkin Study Group (GHSG) HD17 trial established the omission of radiotherapy (RT) for patients with early-stage unfavorable Hodgkin lymphoma being PET-negative after 2 cycles of BEACOPP escalated plus 2 cycles of ABVD. This patient group reveals heterogeneity in characteristics and disease extent which prompted us to perform a decisive dosimetric analysis according to GHSG risk factors. This may help to tailor RT individually balancing risks and benefits. Methods For quality assurance, RT-plans were requested from the treating facilities (n= 141) and analyzed centrally. Dose-volume histograms were scanned either paper-based or digitally to obtain doses to mediastinal organs. These were registered and compared according to GHSG risk factors. Results Overall, RT plans of 176 patients were requested, 139 of which had dosimetric information on target volumes within the mediastinum. Most of these patients were stage II (92.8%), had no B-symptoms (79.1%) and were aged < 50 years (89.9%). Risk factors were present in 8.6% (extranodal involvement), 31.7% (bulky disease), 46.0% (elevated erythrocyte sedimentation rate) and 64.0% (three involved areas), respectively. The presence of bulky disease significantly affected the mean RT doses to the heart (p=0.005) and to the left lung (median: 11.3 Gy vs. 9.9 Gy; p=0.042) as well as V5 of the right and left lung, respectively (median right lung: 67.4% vs. 51.0%; p=0.011; median left lung: 65.9% vs. 54.2%; p=0.008). Significant differences in similar organs at risk parameters could be found between the sub-cohorts with the presence or absence of extranodal involvement, respectively. In contrast, an elevated erythrocyte sedimentation rate did not deteriorate dosimetry significantly. No association of any risk factor with radiation doses to the female breast was found. Conclusion Pre-chemotherapy risk factors may help to predict potential RT exposure to normal organs and to critically review treatment indication. Individualized risk-benefit evaluations for patients with HL in early-stage unfavorable disease are mandatory.
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Affiliation(s)
- Michael Oertel
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Dominik Hering
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Christian Baues
- Department of Radiation Oncology and Cyberknife Center, University Hospital of Cologne, Cologne, Germany
| | - Christopher Kittel
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Michael Fuchs
- Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne, Dusseldorf, University Hospital of Cologne, Cologne, Germany
| | - Jan Kriz
- Department of Radiation Oncology, Alexianer Clemenshospital Muenster, Muenster, Germany
| | - Kai Kröger
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Dirk Vordermark
- Department of Radiation Oncology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Klaus Herfarth
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Rita Engenhart-Cabillic
- Department of Radiotherapy and Radiation Oncology, University Hospital Giessen-Marburg, Marburg, Germany
| | - Peter Lukas
- Department of Radiooncology, Medical University Innsbruck, Innsbruck, Austria
| | - Uwe Haverkamp
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Peter Borchmann
- Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne, Dusseldorf, University Hospital of Cologne, Cologne, Germany
| | - Hans Theodor Eich
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
- *Correspondence: Hans Theodor Eich,
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Oertel M, Hering D, Nacke N, Kittel C, Kröger K, Kriz J, Fuchs M, Baues C, Vordermark D, Engenhart-Cabillic R, Herfarth K, Lukas P, Schmidberger H, Marnitz S, Borchmann P, Engert A, Haverkamp U, Eich HT. P092: Estimating the dosimetric benefit of involved-node radiotherapy in comparison to involved-field radiotherapy - implications from the GHSG HD 17 trial. Hemasphere 2022. [PMCID: PMC9621491 DOI: 10.1097/01.hs9.0000890936.73031.da] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Michael Oertel
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Dominik Hering
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Nina Nacke
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Christopher Kittel
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Kai Kröger
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Jan Kriz
- Department of Radiation Oncology, Alexianer Clemenshospital Muenster, Muenster, Germany
| | - Michael Fuchs
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, University Hospital of Cologne, Cologne, Germany
| | - Christian Baues
- Department of Radiation Oncology and Cyberknife Center, University Hospital of Cologne, Cologne, Germany
| | - Dirk Vordermark
- Department of Radiation Oncology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Rita Engenhart-Cabillic
- Department of Radiotherapy and Radiation Oncology, University Hospital Giessen-Marburg, Marburg, Germany
| | - Klaus Herfarth
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Lukas
- Department of Radiooncology, Medical University Innsbruck, Innsbruck, Austria
| | - Heinz Schmidberger
- Department of Radiotherapy and Radiation Oncology, University Hospital Mainz, Mainz, Germany
| | - Simone Marnitz
- Department of Radiation Oncology and Cyberknife Center, University Hospital of Cologne, Cologne, Germany
| | - Peter Borchmann
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, University Hospital of Cologne, Cologne, Germany
| | - Andreas Engert
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, University Hospital of Cologne, Cologne, Germany
| | - Uwe Haverkamp
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
| | - Hans Theodor Eich
- Department of Radiation Oncology, University Hospital Muenster, Muenster, Germany
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Saudek F, Hladiková Z, Hagerf B, Nemetova L, Girman P, Kriz J, Marada T, Habart D, Berkova Z, Leontovyc I, Fronek J. Transplantation of Pancreatic Islets Into the Omentum Using a Biocompatible Plasma-Thrombin Gel: First Experience at the Institute for Clinical and Experimental Medicine in Prague. Transplant Proc 2022; 54:806-810. [DOI: 10.1016/j.transproceed.2021.11.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/02/2021] [Accepted: 11/18/2021] [Indexed: 01/08/2023]
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Samhouri L, Kriz J, Elsayad K, Channaoui M, Pascher A, Riemann B, Wiewrodt R, Haverkamp U, Scobioala S, Eich HT. The Role of Radiotherapy for Patients With Thyroid Cancer in the Modern Era. Anticancer Res 2020; 40:3379-3386. [PMID: 32487634 DOI: 10.21873/anticanres.14321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/13/2020] [Accepted: 05/06/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Thyroid cancer (TC) is a relatively rare malignancy. The mainstay treatment is surgery followed by radioactive iodine (RAI) and medical systemic treatments. The role of external beam radiotherapy (EBRT) in TC is controversial regarding the survival benefits. The aim of this study was to analyse the effectiveness of EBRT for different forms of TC in different stages. PATIENTS AND METHODS Between January 1990 and 2016, 75 patients underwent 255 radiotherapy (RT) courses at our Institution. Local control (LC) and progression-free survival (PFS) were analyzed. RESULTS The cohort consisted of 22 patients who received curative RT and 53 patients who received RT in a palliative setting. The estimated 5-year LC for the curative group was 92±8% and the palliative group 78±7%. The estimated 5-year PFS for the curative group was 27±9% and for palliative group 31±6%. CONCLUSION The addition of RT in TC seems to be safe and effective. Our analysis showed an excellent local control (median >15 years) regardless of the treatment setting.
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Affiliation(s)
- Laith Samhouri
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
| | - Jan Kriz
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
| | - Khaled Elsayad
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
| | - Mohammed Channaoui
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
| | - Andreas Pascher
- Department of Surgery, University Hospital of Muenster, Muenster, Germany
| | - Burkhard Riemann
- Department of Nuclear Medicine, University Hospital of Muenster, Muenster, Germany
| | - Rainer Wiewrodt
- Department of Oncology and Pneumology, University Hospital of Muenster, Muenster, Germany
| | - Uwe Haverkamp
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
| | - Sergiu Scobioala
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
| | - Hans Theodor Eich
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
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Baues C, Goergen H, Fuchs M, Kobe C, Dietlein M, Rosenbrock J, Celik E, Eich H, Kriz J, Semrau R, Borchmann P, Engert A, Marnitz S. Consolidating Involved Field Radiotherapy Prevents Early and Local Recurrences in Early Stage Hodgkin Lymphoma. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Baues C, Görgen H, Semrau R, Nast-Kolb B, Assenmacher K, Celik E, Morgenthaler J, Rosenbrock J, Trommer M, Houbois C, Kobe C, Kriz J, Engert A, Marnitz S. Volumetric assessment of mediastinal lymphoma masses in Hodgkin lymphoma. Leuk Lymphoma 2019; 60:3244-3250. [PMID: 31232136 DOI: 10.1080/10428194.2019.1623888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The large mediastinal mass (LMM) at initial staging represents a risk factor in Hodgkin lymphoma (HL) and is measured by X-ray. Depending on location of the LMM, different results can occur regardless of the initial lymphoma volume. To assess this risk factor more accurately, we evaluated the method of volumetry in 77 patients of HD13/14 study of the German Hodgkin Study Group. Furthermore, volume calculations based on three or only one diameter, were performed to simplify volume assessment. Inter-rater reliability was good for all methods. The 3-diameter measurement produced larger volumes than volumetric assessment with an intraclass correlation coefficient (ICC) of 0.93, which could be improved to 0.95 by multiplying volumes with a correction factor of 0.86. The 1-dimensional measurement strongly overestimated the volume with an ICC of 0.7. In conclusion, the simplified volume estimation based on 3 largest diameters provides a reliable concept for the staging of HL patients.
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Affiliation(s)
- Christian Baues
- Department of Radiation Oncology and Cyberknife Center, University Hospital of Cologne, Cologne, Germany.,German Hodgkin Study Group, University Hospital of Cologne, Cologne, Germany
| | - Helen Görgen
- German Hodgkin Study Group, University Hospital of Cologne, Cologne, Germany
| | - Robert Semrau
- Radiation Oncology, Bonn-Rhein-Sieg, Siegbur, Germany
| | | | - Katja Assenmacher
- Department of Radiation Oncology and Cyberknife Center, University Hospital of Cologne, Cologne, Germany
| | - Eren Celik
- Department of Radiation Oncology and Cyberknife Center, University Hospital of Cologne, Cologne, Germany
| | - Janis Morgenthaler
- Department of Radiation Oncology and Cyberknife Center, University Hospital of Cologne, Cologne, Germany
| | - Johannes Rosenbrock
- Department of Radiation Oncology and Cyberknife Center, University Hospital of Cologne, Cologne, Germany
| | - Maike Trommer
- Department of Radiation Oncology and Cyberknife Center, University Hospital of Cologne, Cologne, Germany
| | - Christian Houbois
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| | - Carsten Kobe
- Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
| | - Jan Kriz
- Department of Radiation Oncology, University Hospital of Muenster, Munster, Germany
| | - Andreas Engert
- German Hodgkin Study Group, University Hospital of Cologne, Cologne, Germany.,Department of Internal Medicine and Hematology, University Hospital of Cologne, Cologne, Germany
| | - Simone Marnitz
- Department of Radiation Oncology and Cyberknife Center, University Hospital of Cologne, Cologne, Germany.,German Hodgkin Study Group, University Hospital of Cologne, Cologne, Germany
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10
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Kosinova L, Patikova A, Jirak D, Galisova A, Vojtiskova A, Saudek F, Kriz J. A novel model for in vivo quantification of immediate liver perfusion impairment after pancreatic islet transplantation. Islets 2019; 11:129-140. [PMID: 31498024 PMCID: PMC6930024 DOI: 10.1080/19382014.2019.1651164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Instant Blood-Mediated Inflammatory Reaction (IBMIR) is a major cause of graft loss during pancreatic islet transplantation, leading to a low efficiency of this treatment method and significantly limiting its broader clinical use. Within the procedure, transplanted islets obstruct intrahepatic portal vein branches and consequently restrict blood supply of downstream lying liver tissue, resulting typically in ischemic necrosis. The extent of ischemic lesions is influenced by mechanical obstruction and inflammation, as well as subsequent recanalization and regeneration capacity of recipient liver tissue. Monitoring of immediate liver perfusion impairment, which is directly related to the intensity of post-transplant inflammation and thrombosis (IBMIR), is essential for improving therapeutic and preventive strategies to improve overall islet graft survival. In this study, we present a new experimental model enabling direct quantification of liver perfusion impairment after pancreatic islet transplantation using ligation of hepatic arteries followed by contrast-enhanced magnetic resonance imaging (MRI). The ligation of hepatic arteries prevents the contrast agent from circumventing the portal vein obstruction and enables to discriminate between well-perfused and non-perfused liver tissue. Here we demonstrate that the extent of liver ischemia reliably reflects the number of transplanted islets. This model represents a useful tool for in vivo monitoring of biological effect of IBMIR-alleviating interventions as well as other experiments related to liver ischemia. This technical paper introduces a novel technique and its first application in experimental animals.
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Affiliation(s)
- Lucie Kosinova
- Laboratory of Pancreatic Islets, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- First Faculty of Medicine, Charles University, Prague, Czech Republic
- CONTACT Jan Kriz Laboratory of Pancreatic Islets, Institute for Clinical and Experimental Medicine, Videnska 1958/9, Prague, Czech Republic
| | - Alzbeta Patikova
- Laboratory of Pancreatic Islets, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Daniel Jirak
- Magnetic Resonance Unit, Radiodiagnostic and Interventional Radiology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- Institute of Biophysics and Informatics, Charles University, Prague, Czech Republic
| | - Andrea Galisova
- Magnetic Resonance Unit, Radiodiagnostic and Interventional Radiology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Alzbeta Vojtiskova
- Laboratory of Pancreatic Islets, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Frantisek Saudek
- Laboratory of Pancreatic Islets, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- Diabetes Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Jan Kriz
- Laboratory of Pancreatic Islets, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- Diabetes Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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11
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Abstract
Fowler's syndrome (FS) is a rare cause of chronic urinary retention in teenage girls and young women. We present a case of a 14-year-old girl who presented at our hospital 2 weeks after uncomplicated laparoscopic appendectomy. The girl complained of reduced urinary frequency and prolonged micturition time. Following an acute cystitis 2 months later, she completely lost her ability to void. A comprehensive set of investigations to assess the cause of her urinary retention including a cerebral and spinal magnetic resonance imaging (MRI), and videourodynamics were performed. The diagnostic workup revealed polycystic ovaries and an asensitive and hypotonic bladder with capacity up to 1200 mL and high maximum urethral pressure of 120 cm of water. She did not tolerate clean intermittent catheterization; therefore, a suprapubic catheter was placed. Under this treatment, she suffered recurrent urinary tract infections. Two years later, she was diagnosed with FS on the basis of the medical history, clinical symptoms, and urodynamic findings. Finally, the implantation of a S3 neurostimulator restored her ability to void.
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Affiliation(s)
- Jan Trachta
- Department of Paediatric Surgery and Urology, Motol University Hospital, Charles University in Prague, Prague, Czech Republic
| | - Johann Wachter
- Department of Urology, Kaiser-Franz-Josef Spital, Wien, Austria
| | - Jan Kriz
- Department of Paediatric Surgery and Urology, Motol University Hospital, Charles University in Prague, Prague, Czech Republic
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12
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Garcia Ribeiro RS, Gysemans C, da Cunha JPMCM, Manshian BB, Jirak D, Kriz J, Gallo J, Bañobre-López M, Struys T, De Cuyper M, Mathieu C, Soenen SJ, Gsell W, Himmelreich U. Magnetoliposomes as Contrast Agents for Longitudinal in vivo Assessment of Transplanted Pancreatic Islets in a Diabetic Rat Model. Sci Rep 2018; 8:11487. [PMID: 30065302 PMCID: PMC6068133 DOI: 10.1038/s41598-018-29136-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 06/12/2018] [Indexed: 01/07/2023] Open
Abstract
Magnetoliposomes (MLs) were synthesized and tested for longitudinal monitoring of transplanted pancreatic islets using magnetic resonance imaging (MRI) in rat models. The rat insulinoma cell line INS-1E and isolated pancreatic islets from outbred and inbred rats were used to optimize labeling conditions in vitro. Strong MRI contrast was generated by islets exposed to 50 µg Fe/ml for 24 hours without any increased cell death, loss of function or other signs of toxicity. In vivo experiments showed that pancreatic islets (50-1000 units) labeled with MLs were detectable for up to 6 weeks post-transplantation in the kidney subcapsular space. Islets were also monitored for two weeks following transplantation through the portal vein of the liver. Hereby, islets labeled with MLs and transplanted under the left kidney capsule were able to correct hyperglycemia and had stable MRI signals until nephrectomy. Interestingly, in vivo MRI of streptozotocin induced diabetic rats transplanted with allogeneic islets demonstrated loss of MRI contrast between 7-16 days, indicative of loss of islet structure. MLs used in this study were not only beneficial for monitoring the location of transplanted islets in vivo with high sensitivity but also reported on islet integrity and hereby indirectly on islet function and rejection.
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Affiliation(s)
- Rita Sofia Garcia Ribeiro
- Biomedical MRI/MoSAIC, Department of Imaging and Pathology, Biomedical Sciences Group, KU LEUVEN, Herestraat 49, 3000, Leuven, Belgium
| | - Conny Gysemans
- Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU LEUVEN, Herestraat 49, 3000, Leuven, Belgium
| | | | - Bella B Manshian
- Biomedical MRI/MoSAIC, Department of Imaging and Pathology, Biomedical Sciences Group, KU LEUVEN, Herestraat 49, 3000, Leuven, Belgium
| | - Daniel Jirak
- MR Spectroscopy Unit, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, 140 21, Prague, Czech Republic
- Department of Biophysics, Institute of Biophysics and Informatics, First Faculty of Medicine, Charles University, Salmovska 1, 120 00, Prague 2, Czech Republic
| | - Jan Kriz
- Diabetes Center, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, 140 21, Prague, Czech Republic
| | - Juan Gallo
- Diagnostic Tools & Methods/Advanced (magnetic) Theranostic Nanostructures Lab, International Iberian Nanotechnology Laboratory (INL), Av. Mestre José Veiga s/n, 4715-330, Braga, Portugal
| | - Manuel Bañobre-López
- Diagnostic Tools & Methods/Advanced (magnetic) Theranostic Nanostructures Lab, International Iberian Nanotechnology Laboratory (INL), Av. Mestre José Veiga s/n, 4715-330, Braga, Portugal
| | - Tom Struys
- Lab of Histology, Biomedical Research Institute, Hasselt University, Campus Diepenbeek, Agoralaan, B3590, Diepenbeek, Belgium
| | - Marcel De Cuyper
- Laboratory of BioNanoColloids, Interdisciplinary Research Centre, KULAK/KU LEUVEN, Etienne Sabbelaan 53, 8500, Kortrijk, Belgium
| | - Chantal Mathieu
- Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU LEUVEN, Herestraat 49, 3000, Leuven, Belgium
| | - Stefaan J Soenen
- Biomedical MRI/MoSAIC, Department of Imaging and Pathology, Biomedical Sciences Group, KU LEUVEN, Herestraat 49, 3000, Leuven, Belgium
| | - Willy Gsell
- Biomedical MRI/MoSAIC, Department of Imaging and Pathology, Biomedical Sciences Group, KU LEUVEN, Herestraat 49, 3000, Leuven, Belgium
| | - Uwe Himmelreich
- Biomedical MRI/MoSAIC, Department of Imaging and Pathology, Biomedical Sciences Group, KU LEUVEN, Herestraat 49, 3000, Leuven, Belgium.
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13
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Schliemann C, Kerkhoff A, Hesse P, Bröckling S, Hardes J, Streitbürger A, Andreou D, Gosheger G, Elges S, Wardelmann E, Hartmann W, Mesters R, Lenz G, Willich N, Kriz J, Eich H, Berdel WE, Kessler T. Adjuvant chemotherapy-Radiotherapy-Chemotherapy sandwich protocol in resectable soft tissue sarcoma: An updated single-center analysis of 104 cases. PLoS One 2018; 13:e0197315. [PMID: 29787570 PMCID: PMC5963910 DOI: 10.1371/journal.pone.0197315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 03/17/2018] [Indexed: 01/20/2023] Open
Abstract
Adjuvant therapy of local soft tissue sarcomas (STS) after wide surgical excision still is a topic under controversial scientific debate. In this single center report we have offered an adjuvant “sandwich” therapy protocol consisting of 4 cycles of doxorubicin (75 mg/m2 i.v. over 1 h on day 1) followed by ifosfamide (5 g/m2 i.v. over 24 h starting on day 1) and local radiotherapy scheduled between chemotherapy cycles 2 and 3 to 104 consecutive patients after wide surgical excision (R0) of histologically proven high-grade STS. After a mean follow-up of 39 months (range 5–194 months) relapse free survival (RFS) at 2 and 5 years was 68.1% (95% CI, 58.5–77.7%) and 61.2% (95% CI, 50.4–71.6%). When analyzing the 82 STS cases of the extremities only 2- and 5-year RFS was 74.0% (95% CI, 64.0–84.0%) and 65.3% (95% CI, 53.7–76.9%). By intent-to-treat analysis, the overall survival (OS) at 2 years was 87.3% (95% CI, 80.5–94.1%) and 75.6% (95% CI, 65.2–86.0%) at 5 years, while OS for STS of the extremities only cohort was 90.5% (95% CI, 83.7–97.3%) and 79.0% (95% CI, 68.4–89.6%), respectively. Tolerability of the treatment was good. This analysis demonstrates the feasibility of adjuvant chemoradiotherapy and reflects the results of the long lasting intensive multidisciplinary team approach at our “high-volume” sarcoma center. The long-term survival in our patients is among the highest reported and the low local and distant recurrence rate in high-risk STS is at least comparable to the published data.
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Affiliation(s)
| | - Andrea Kerkhoff
- University Hospital Muenster, Department of Medicine A, Muenster, Germany
| | - Paula Hesse
- University Hospital Muenster, Department of Medicine A, Muenster, Germany
| | | | - Jendrik Hardes
- University Hospital Muenster, Department of Orthopedics and Tumororthopedics, Muenster, Germany
| | - Arne Streitbürger
- University Hospital Muenster, Department of Orthopedics and Tumororthopedics, Muenster, Germany
| | - Dimosthenis Andreou
- University Hospital Muenster, Department of Orthopedics and Tumororthopedics, Muenster, Germany
| | - Georg Gosheger
- University Hospital Muenster, Department of Orthopedics and Tumororthopedics, Muenster, Germany
| | - Sandra Elges
- University Hospital Muenster, Gerhard-Domagk-Institute for Pathology, Muenster, Germany
| | - Eva Wardelmann
- University Hospital Muenster, Gerhard-Domagk-Institute for Pathology, Muenster, Germany
| | - Wolfgang Hartmann
- University Hospital Muenster, Gerhard-Domagk-Institute for Pathology, Muenster, Germany
| | - Rolf Mesters
- University Hospital Muenster, Department of Medicine A, Muenster, Germany
| | - Georg Lenz
- University Hospital Muenster, Department of Medicine A, Muenster, Germany
| | - Normann Willich
- University Hospital Muenster, Department of Radiation Oncology, Muenster, Germany
| | - Jan Kriz
- University Hospital Muenster, Department of Radiation Oncology, Muenster, Germany
| | - Hans Eich
- University Hospital Muenster, Department of Radiation Oncology, Muenster, Germany
| | - Wolfgang E. Berdel
- University Hospital Muenster, Department of Medicine A, Muenster, Germany
| | - Torsten Kessler
- University Hospital Muenster, Department of Medicine A, Muenster, Germany
- * E-mail:
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14
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Kriz J, Seegenschmiedt HM, Bartels A, Micke O, Muecke R, Schaefer U, Haverkamp U, Eich HT. Updated strategies in the treatment of benign diseases-a patterns of care study of the german cooperative group on benign diseases. Adv Radiat Oncol 2018; 3:240-244. [PMID: 30197936 PMCID: PMC6127969 DOI: 10.1016/j.adro.2018.02.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/13/2018] [Accepted: 02/20/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose Radiation therapy (RT) is a common treatment for benign diseases in Germany. Because the treatment concepts are inconsistent, we conducted this pattern-of-care study on behalf of the German Cooperative Group on Benign Diseases to evaluate treatment standards in Germany. Methods and materials Questionnaires were mailed to all radiation therapy facilities in Germany. We assessed the treatment equipment, annual number of patients, treatment indications, and, in particular, treatment strategies in patients with benign diseases in 2014. Results We evaluated questionnaires returned by 116 participating institutions, of which 41 were ambulatory health care centers, 28 were private institutions, 27 were community hospitals, and 20 were university hospitals. On average, 2 linac accelerators and 2 megavoltage units were available in each institution. In 2014, a total of 36,830 patients were treated for benign diseases: 16,989 for degenerative diseases (peritendinitis humeroscapularis n = 2691; epicondylitis humeri n = 3788; heel spur n = 10,510); 14,936 for osteoarthritis (coxarthrosis n = 2230; gonarthrosis n = 2623; omarthrosis n = 2691; rhizarthrosis n = 2440; polyarthrosis n = 2297; others n = 2655); 1563 for hyperproliferative diseases (morbus Dupuytren n = 960; morbus Ledderhose n = 441; keloids n = 139; pterygium of the conjunctiva n = 3; other hyperproliferative diseases n = 20); 2440 for functional disorders (gynecomastia n = 843; Graves' disease n = 205; lymphatic fistula n = 178; heterotopic ossification prophylaxis n = 1214); 859 for stereotactic RT in the central nervous system (arteriovenous malformation n = 53; meningioma n = 425; acoustic neuroma n = 201; pituitary adenoma n = 131; others n = 49), and 43 for rare indications (pigmented villonodular synovitis n = 20 or vertebral hemangioma n = 23). The mean whole dose was <10 Gy in the treatment of degenerative disorders, 25 Gy for hyperproliferative diseases, 15 Gy for functional disorders, and <50 Gy for stereotactic RT. Conclusions In 2014, RT had an important role in the treatment of benign diseases. Because treatment concepts are inherent, we recommend treatment based on the guidelines written by the German Cooperative Group on Benign Diseases.
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Affiliation(s)
- Jan Kriz
- Department of Radiation Oncology, University of Muenster, Muenster, Germany
| | | | - Amelie Bartels
- Department of Radiation Oncology, University of Muenster, Muenster, Germany
| | - Oliver Micke
- Department of Radiation Oncology, Franziskus Hospital, Bielefeld, Germany
| | - Ralph Muecke
- Department of Radiotherapy and Radiation Oncology, Marien Hospital Herne, Ruhr University Bochum, Bochum, Germany.,Private Practice for Radiotherapy RheinMainNahe, Bad Kreuznach, Germany
| | - Ulrich Schaefer
- Department of Radiation Oncology, Klinikum Lemgo, Lemgo, Germany
| | - Uwe Haverkamp
- Department of Radiation Oncology, University of Muenster, Muenster, Germany
| | - Hans T Eich
- Department of Radiation Oncology, University of Muenster, Muenster, Germany
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15
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Leontovyc I, Habart D, Loukotova S, Kosinova L, Kriz J, Saudek F, Koblas T. Synthetic mRNA is a more reliable tool for the delivery of DNA-targeting proteins into the cell nucleus than fusion with a protein transduction domain. PLoS One 2017; 12:e0182497. [PMID: 28806415 PMCID: PMC5555570 DOI: 10.1371/journal.pone.0182497] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 07/19/2017] [Indexed: 12/17/2022] Open
Abstract
Cell reprogramming requires efficient delivery of reprogramming transcription factors into the cell nucleus. Here, we compared the robustness and workload of two protein delivery methods that avoid the risk of genomic integration. The first method is based on fusion of the protein of interest to a protein transduction domain (PTD) for delivery across the membranes of target cells. The second method relies on de novo synthesis of the protein of interest inside the target cells utilizing synthetic mRNA (syn-mRNA) as a template. We established a Cre/lox reporter system in three different cell types derived from human (PANC-1, HEK293) and rat (BRIN-BD11) tissues and used Cre recombinase to model a protein of interest. The system allowed constitutive expression of red fluorescence protein (RFP), while green fluorescence protein (GFP) was expressed only after the genomic action of Cre recombinase. The efficiency of protein delivery into cell nuclei was quantified as the frequency of GFP+ cells in the total cell number. The PTD method showed good efficiency only in BRIN-BD11 cells (68%), whereas it failed in PANC-1 and HEK293 cells. By contrast, the syn-mRNA method was highly effective in all three cell types (29-71%). We conclude that using synthetic mRNA is a more robust and less labor-intensive approach than using the PTD-fusion alternative.
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Affiliation(s)
- Ivan Leontovyc
- Department of Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - David Habart
- Department of Diabetes, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Sarka Loukotova
- Department of Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Lucie Kosinova
- Department of Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Jan Kriz
- Department of Diabetes, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Frantisek Saudek
- Department of Diabetes, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Tomas Koblas
- Department of Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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16
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Kriz J, Eich HT. Quantitative Risikoabschätzung einer Herzinsuffizienz bei Patienten mit Hodgkin-Lymphom nach Strahlentherapie und anthrazyklinhaltiger Chemotherapie. Strahlenther Onkol 2017; 193:677-678. [DOI: 10.1007/s00066-017-1169-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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17
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Herynek V, Gálisová A, Srinivas M, van Dinther EAW, Kosinová L, Ruzicka J, Jirátová M, Kriz J, Jirák D. Pre-Microporation Improves Outcome of Pancreatic Islet Labelling for Optical and 19F MR Imaging. Biol Proced Online 2017; 19:6. [PMID: 28674481 PMCID: PMC5488379 DOI: 10.1186/s12575-017-0055-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 06/01/2017] [Indexed: 01/02/2023] Open
Abstract
Background In vitro labelling of cells and small cell structures is a necessary step before in vivo monitoring of grafts. We modified and optimised a procedure for pancreatic islet labelling using bimodal positively charged poly(lactic-co-glycolic acid) nanoparticles with encapsulated perfluoro crown ethers and indocyanine green dye via microporation and compared the method with passive endocytosis. Results Pancreatic islets were microporated using two pulses at various voltages. We tested a standard procedure (poration in the presence of nanoparticles) and a modified protocol (pre-microporation in a buffer only, and subsequent islet incubation with nanoparticles on ice for 10 min). We compared islet labelling by microporation with labelling by endocytosis, i.e. pancreatic islets were incubated for 24 h in a medium with suspended nanoparticles. In order to verify the efficiency of the labelling procedures, we used 19F magnetic resonance imaging, optical fluorescence imaging and confocal microscopy. The experiment confirmed that microporation, albeit fast and effective, is invasive and may cause substantial harm to islets. To achieve sufficient poration and to minimise the reduction of viability, the electric field should be set at 20 kV/m (two pulses, 20 ms each). Poration in the presence of nanoparticles was found to be unsuitable for the nanoparticles used. The water suspension of nanoparticles (which served as a surfactant) was slightly foamy and microbubbles in the suspension were responsible for sparks causing the destruction of islets during poration. However, pre-microporation (poration of islets in a buffer only) followed by 10-min incubation with nanoparticles was safer. Conclusions For labelling of pancreatic islets using poly(lactic-co-glycolic acid) nanoparticles, the modified microporation procedure with low voltage was found to be safer than the standard microporation procedure. The modified procedure was fast, however, efficiency was lower compared to endocytosis.
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Affiliation(s)
- Vít Herynek
- MR Unit, Radiodiagnostic and Interventional Radiology Department, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, Prague, Czech Republic
| | - Andrea Gálisová
- MR Unit, Radiodiagnostic and Interventional Radiology Department, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, Prague, Czech Republic
| | - Mangala Srinivas
- Department of Tumor Immunology, Radboud University Medical Centre, Route 278, Geert Grooteplein 28, Nijmegen, Netherlands
| | - Eric A W van Dinther
- Department of Tumor Immunology, Radboud University Medical Centre, Route 278, Geert Grooteplein 28, Nijmegen, Netherlands
| | - Lucie Kosinová
- Centre of Experimental Medicine, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, Prague, Czech Republic
| | - Jiri Ruzicka
- MR Unit, Radiodiagnostic and Interventional Radiology Department, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, Prague, Czech Republic.,Department of Tissue Culture and Stem Cells, Institute of Experimental Medicine AS CR, Vídeňská 1083, 142 20, Prague, Czech Republic
| | - Markéta Jirátová
- MR Unit, Radiodiagnostic and Interventional Radiology Department, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, Prague, Czech Republic
| | - Jan Kriz
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, Prague, Czech Republic
| | - Daniel Jirák
- MR Unit, Radiodiagnostic and Interventional Radiology Department, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, Prague, Czech Republic
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18
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Kriz J, Seegenschmiedt H, Bartels A, Micke O, Muecke R, Schaefer U, Haverkamp U, Eich H. Updated Strategies in the Treatment of Benign Diseases—A Patterns of Care Study of the German Cooperative Group on Benign Diseases. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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19
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Kriz J, Baues C, Engenhart-Cabillic R, Haverkamp U, Herfarth K, Lukas P, Schmidberger H, Marnitz-Schulze S, Fuchs M, Engert A, Eich HT. New quality assurance program integrating "modern radiotherapy" within the German Hodgkin Study Group. Strahlenther Onkol 2016; 193:100-108. [PMID: 27678010 DOI: 10.1007/s00066-016-1048-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/29/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Field design changed substantially from extended-field RT (EF-RT) to involved-field RT (IF-RT) and now to involved-node RT (IN-RT) and involved-site RT (IS-RT) as well as treatment techniques in radiotherapy (RT) of Hodgkin's lymphoma (HL). The purpose of this article is to demonstrate the establishment of a quality assurance program (QAP) including modern RT techniques and field designs within the German Hodgkin Study Group (GHSG). METHODS In the era of modern conformal RT, this QAP had to be fundamentally adapted and a new evaluation process has been intensively discussed by the radiotherapeutic expert panel of the GHSG. RESULTS The expert panel developed guidelines and criteria to analyse "modern" field designs and treatment techniques. This work is based on a dataset of 11 patients treated within the sixth study generation (HD16-17). CONCLUSION To develop a QAP of "modern RT", the expert panel defined criteria for analysing current RT procedures. The consensus of a modified QAP in ongoing and future trials is presented. With this schedule, the QAP of the GHSG could serve as a model for other study groups.
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Affiliation(s)
- J Kriz
- Department of Radiation Oncology, University of Muenster, Albert-Schweitzer Campus 1, Gebäude 1 A, 48419, Muenster, Germany
| | - C Baues
- Department of Radiation Oncology, University of Cologne, Köln, Deutschland
| | | | - U Haverkamp
- Department of Radiation Oncology, University of Muenster, Albert-Schweitzer Campus 1, Gebäude 1 A, 48419, Muenster, Germany
| | - K Herfarth
- Department of Radiation Oncology, University of Heidelberg, Heidelberg, Deutschland
| | - P Lukas
- Department of Radiation Oncology, University of Innsbruck, Innsbruck, Deutschland
| | - H Schmidberger
- Department of Radiation Oncology, University of Mainz, Mainz, Deutschland
| | - S Marnitz-Schulze
- Department of Radiation Oncology, University of Cologne, Köln, Deutschland
| | - M Fuchs
- Department of Internal Medicine, University of Cologne, Köln, Deutschland
| | - A Engert
- Department of Internal Medicine, University of Cologne, Köln, Deutschland
| | - H T Eich
- Department of Radiation Oncology, University of Muenster, Albert-Schweitzer Campus 1, Gebäude 1 A, 48419, Muenster, Germany.
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20
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Kriz J, Baues C, Engenhart-Cabillic R, Haverkamp U, Herfart K, Lukas P, Plütschow A, Schmidberger H, Staar S, Fuchs M, Engert A, Eich HT. Quality control of involved field radiotherapy in the HD 13 and HD 14 trials : Report of the radiotherapy panel of the German Hodgkin Study Group (GHSG). Strahlenther Onkol 2016; 193:109-115. [PMID: 27596217 DOI: 10.1007/s00066-016-1036-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/02/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION As part of the foundation of the German Hodgkin Study Group (GHSG) in 1978, a central radiotherapy (RT) reference centre was established to evaluate and to improve the quality of treatment. During the study generations, the quality assurance programs (QAP) were continued and adapted to the demands of each study. The purpose of this article is to demonstrate the results of the fifth study generation and to compare them to the previous findings. METHODS With the start of the fourth GHSG study generation (HD10-12), a central prospective review of all diagnostic images was established to create an individual treatment plan for each early stage study patient. The quality of involved field RT was retrospectively evaluated by an expert panel of radiation oncologists. In the fifth study generation (HD13-15), the retrospective review of radiotherapy performed was refined and the results were compared with the findings of the fourth generation. RESULTS The expert panel analyzed the RT planning and application of 1037 (28 %) patients (HD13 n = 465, HD14 n = 572). Simulation films were available in 85 % of cases and verification films in 87 %. RT was assessed as major violation in 46 % (HD13 = 38 %, HD14 = 52 %), minor violation in 9 % (HD13 = 9 %, HD14 = 9 %) and according to the protocol in 45 % (HD13 = 52 %, HD14 = 38 %). CONCLUSION The value for QAP of RT within the GHSG trials is well known. Still there were several protocol violations. In the future, the QAP program has to be adapted to the requirements of "modern RT" in malignant lymphoma.
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Affiliation(s)
- J Kriz
- Department of Radiation Oncology, University of Muenster, Albert-Schweitzer Campus 1, Gebäude 1 A, 48419, Muenster, Germany
| | - C Baues
- Department of Radiation Oncology, University of Cologne, Cologne, Germany
| | | | - U Haverkamp
- Department of Radiation Oncology, University of Muenster, Albert-Schweitzer Campus 1, Gebäude 1 A, 48419, Muenster, Germany
| | - K Herfart
- Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany
| | - P Lukas
- Department of Radiation Oncology, University of Innsbruck, Innsbruck, Austria
| | - A Plütschow
- Department of Internal Medicine, University of Cologne, Cologne, Germany
| | - H Schmidberger
- Department of Radiation Oncology, University of Mainz, Mainz, Germany
| | - S Staar
- Department of Radiation Oncology, Bremen Mitte, Bremen, Germany
| | - M Fuchs
- Department of Internal Medicine, University of Cologne, Cologne, Germany
| | - A Engert
- Department of Internal Medicine, University of Cologne, Cologne, Germany
| | - H T Eich
- Department of Radiation Oncology, University of Muenster, Albert-Schweitzer Campus 1, Gebäude 1 A, 48419, Muenster, Germany.
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Habibeh O, Elsayad K, Kriz J, Haverkamp U, Eich HT. Post-transplant lymphoproliferative disorder in the pelvis successfully treated with consolidative radiotherapy. Strahlenther Onkol 2016; 193:80-85. [DOI: 10.1007/s00066-016-1006-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/20/2016] [Indexed: 12/22/2022]
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Elsayad K, Scobioala S, Kriz J, Haverkamp U, Eich HT. Advances in Image-Guided Radiation Therapy for Primary Cardiac Angiosarcoma: The Role of PET-CT and MRI. Oncol Res Treat 2016; 39:290-4. [DOI: 10.1159/000445864] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/17/2016] [Indexed: 11/19/2022]
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Abstract
AIM The aim of this study was to analyze complications and outcomes of end-to-end urethral anastomosis performed for posttraumatic bulbar strictures or posterior urethral injuries in pediatric patients. METHODS The records of 15 boys, age 18 years and below, admitted to our tertiary trauma center with urethral injuries from 1989 to 2014 were reviewed retrospectively. Out of these 15 boys, 7 were excluded (2 for iatrogenic trauma, 2 for minor straddle injuries who were not operated on, 2 for incomplete records, and 1 lost to follow-up) and 8 analyzed patients were operated for bulbar or posterior urethral injury. The mean follow-up after the operation was 4.5 years (range 0.5-10). To obtain up-to-date follow-up information, all the analyzed patients were contacted by a letter and telephone in January 2015 and asked about lower urinary tract or erectile dysfunction (ED) using the International Index of Erectile Function-5 questionnaire. RESULTS Mean age at the time of injury was 12.3 years (range 5-17). Four patients with pelvic fracture had complete posterior urethra disruption, three patients after straddle injury developed obliterating stricture of the bulbar urethra and one patient had torn his bulbar urethra apart by a sharp hook. Except for the immediate exploration of the open perineal wound, all patients were operated via perineal approach 1 to 6 months after initial suprapubic catheter insertion. Five patients needed a cystotomy to identify the proximal urethral stump by a probe, and two patients had partial pubectomy to gain urethral length. Postoperative complications included stricture in anastomosis in six patients (all reoperated, four more than once including attempts of endoscopic internal urethrotomy). Six days after surgery, one patient developed massive external bleeding around a permanent urinary catheter due to a posttraumatic ruptured arterial aneurysm that was later stopped by urgent angiography and coil insertion. After discharge, three patients had transient stress incontinence. All patients had uroflowmetry maximum flow above 20 mL/s on their last follow-up except for two (12 and 15 mL/s). None have any lower urinary tract dysfunction symptoms in adulthood; one suffers from mild ED and two report moderate ED due to penile shortening. CONCLUSION Delayed end-to-end anastomosis for pediatric urethral injury is a safe operational option. However, high rate of short-term complications and reoperations should be expected. Penile shortening is one of the most severe long-term complications.
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Affiliation(s)
- Jan Trachta
- Department of Paediatric Surgery, Motol University Hospital, Prague, Czech Republic
| | - Jiri Moravek
- Department of Paediatric Surgery, Motol University Hospital, Prague, Czech Republic
| | - Jan Kriz
- Department of Paediatric Surgery, Motol University Hospital, Prague, Czech Republic
| | - Radek Padr
- Department of Radiology, Motol University Hospital, Prague, Czech Republic
| | - Richard Skaba
- Department of Paediatric Surgery, Motol University Hospital, Prague, Czech Republic
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Berkova Z, Saudek F, Girman P, Zacharovova K, Kriz J, Fabryova E, Leontovyc I, Koblas T, Kosinova L, Neskudla T, Vavrova E, Habart D, Loukotova S, Zahradnicka M, Lipar K, Voska L, Skibova J. Combining Donor Characteristics with Immunohistological Data Improves the Prediction of Islet Isolation Success. J Diabetes Res 2016; 2016:4214328. [PMID: 27803935 PMCID: PMC5075626 DOI: 10.1155/2016/4214328] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/01/2016] [Indexed: 11/18/2022] Open
Abstract
Variability of pancreatic donors may significantly impact the success of islet isolation. The aim of this study was to evaluate donor factors associated with isolation failure and to investigate whether immunohistology could contribute to organ selection. Donor characteristics were evaluated for both successful (n = 61) and failed (n = 98) islet isolations. Samples of donor pancreatic tissue (n = 78) were taken for immunohistochemical examination. Islet isolations with 250000 islet equivalents were considered successful. We confirmed that BMI of less than 25 kg/m2 (P < 0.001), cold ischemia time more than 8 hours (P < 0.01), hospitalization longer than 96 hours (P < 0.05), higher catecholamine doses (P < 0.05), and edematous pancreases (P < 0.01) all unfavorably affected isolation outcome. Subsequent immunohistochemical examination of donor pancreases confirmed significant differences in insulin-positive areas (P < 0.001). ROC analyses then established that the insulin-positive area in the pancreas could be used to predict the likely success of islet isolation (P < 0.001). At the optimal cutoff point (>1.02%), sensitivity and specificity were 89% and 76%, respectively. To conclude, while the insulin-positive area, determined preislet isolation, as a single variable, is sufficient to predict isolation outcome and helps to improve the success of this procedure, its combination with the established donor scoring system might further improve organ selection.
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Affiliation(s)
- Zuzana Berkova
- Laboratory of Pancreatic Islets, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Frantisek Saudek
- Department of Diabetes, Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- *Frantisek Saudek:
| | - Peter Girman
- Department of Diabetes, Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Klara Zacharovova
- Laboratory of Pancreatic Islets, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Jan Kriz
- Department of Diabetes, Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Eva Fabryova
- Laboratory of Pancreatic Islets, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Ivan Leontovyc
- Laboratory of Pancreatic Islets, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Tomas Koblas
- Laboratory of Pancreatic Islets, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Lucie Kosinova
- Laboratory of Pancreatic Islets, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Tomas Neskudla
- Department of Diabetes, Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Ema Vavrova
- Department of Diabetes, Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - David Habart
- Department of Diabetes, Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Sarka Loukotova
- Laboratory of Pancreatic Islets, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Martina Zahradnicka
- Department of Diabetes, Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Kvetoslav Lipar
- Transplant Surgery Department, Transplant Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Ludek Voska
- Department of Clinical and Transplant Pathology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Jelena Skibova
- Department of Medical Statistics, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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Kriz J, Fabryova E, Sticova E, Papackova Z, Koblas T, Cahova M, Saudek F. Formation of Cholangiogenic Cysts Following Intrahepatic Islet Transplantation in Streptozotocin Diabetic Rats. Transplant Proc 2015; 47:2763-7. [PMID: 26680089 DOI: 10.1016/j.transproceed.2015.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 06/17/2015] [Accepted: 07/08/2015] [Indexed: 02/07/2023]
Abstract
Permanent hyperinsulinemia and the resulting overstimulation of the insulin receptor signaling pathway is suspected as a trigger of cancer genesis in the livers of type 2 diabetic patients. Liver tissue (LT) surrounding transplanted pancreatic islets (PI) can be permanently exposed to insulin in even higher concentrations than in type 2 diabetic patients. Therefore, this study examines the effect of PI transplantation (Tx) on LT in animals with streptozotocin (STZ)-induced diabetes mellitus. The suboptimal mass (400 or 1000) of isogeneic PI was transplanted into either the portal vein or under the kidney capsule of diabetic Brown Norway (BN) rats. Healthy BN rats treated with 400 isogeneic PI transplanted in the portal vein served as a control group. During the first 6 months after PI Tx, small and infrequent cystic lesions developed in animals with STZ diabetes, irrespective of the Tx site. In 10 months, frequent and complex cystic lesions appeared in these animals. In the control group, several small lesions were detected but not until 10 months after the PI Tx. In summary, STZ is the likely main inductor of hepatic cystic lesions, but the contribution of PI was not confirmed.
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Affiliation(s)
- J Kriz
- Diabetes Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
| | - E Fabryova
- Center of Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - E Sticova
- Department of Clinical and Transplant Pathology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Z Papackova
- Center of Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - T Koblas
- Center of Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - M Cahova
- Center of Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - F Saudek
- Diabetes Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Center of Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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Kriz J, Plütschow A, Engenhart-Cabillic R, Herfarth K, Lukas P, Schmidberger H, Staar S, Haverkamp U, Baues C, Engert A, Eich H. Quality Assurance of Involved Field Radiation Therapy Within the HD13 and HD14 Trial (early stages) of the German Hodgkin Study Group. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kriz J, Spickermann M, Lehrich P, Schmidberger H, Reinartz G, Haverkamp U, Eich H. Breath Hold Technique in Conventional APPA or Intensity Modulated Radiation Therapy for Patients With Hodgkin Lymphoma: Testing the ILROG “IS-RT” Versus the GHSG “IF-RT”. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Elsayad K, Bauch J, Moustakis C, Reinartz G, Kriz J, Haverkamp U, Eich H. Total Skin Electron Beam Therapy for Mycosis Fungoides and Sézary Syndrome: The Influence of Delivered Radiation Dose on the Clinical Outcome. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kriz J, Engenhart-Cabillic R, Haverkamp U, Herfarth K, Lukas P, Schmidberger H, Staar S, Engert A, Eich H. Establishing a New Quality Assurance Program of “Modern” Radiation Therapy Within the German Hodgkin Study Group. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Elsayad K, Scobioala S, Kriz J, Ernst I, Haverkamp U, Eich H. Image Guided and Adaptive Radiation Therapy for Lung Cancer Using Kilovoltage Cone Beam CT: A Quantitative Volumetric Analysis During Treatment Course. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kobe C, Kuhnert G, Haverkamp H, Fuchs M, Kahraman D, Eich HT, Kriz J, Baues C, Nast-Kolb B, Bröckelmann PJ, Borchmann P, Drzezga A, Engert A, Dietlein M. Concordance in the interpretation of PET after chemotherapy in advanced stage Hodgkin lymphoma. Nuklearmedizin 2015; 54:241-6. [PMID: 26388152 DOI: 10.3413/nukmed-0746-15-06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 09/16/2015] [Indexed: 01/27/2023]
Abstract
UNLABELLED The aim was to analyze the degree of agreement between the central review panel and the local PET interpretation within the HD15 trial and its impact on subsequent treatment and progression free survival. PATIENTS, METHODS The analysis set consisted of 739 patients with residues ≥ 2.5 cm after 6 or 8 cycles of BEACOPPesc from the HD15 trial performed by the German Hodgkin Study Group. The recommendation for or against further radiotherapy was based on the central [(18)F]FDG-PET interpretation. Central PET interpretation was compared to the local PET interpretation and concordance was measured using Cohen's Kappa coefficient. Prognostic impact of the analysis of concordance between local and central PET interpretations was evaluated using progression free survival (PFS); groups were compared with the log rank test. RESULTS The central panel rated 548 of 739 patients (74%) as PET negative. Of these, 513 were also rated as PET negative in the local PET interpretation. PET positivity was seen by central reviewers in the remaining 191 patients (26%), in concordance with local reviewers in 155 cases. Even though substantial agreement was found (Cohen's Kappa 0.81), the interpretation of the central PET review panel led to a different therapeutic recommendation in 71/739 (10%) patients. PFS was equally high in groups in which the therapeutic regime had been changed on the basis of the central panel decision. CONCLUSION High concordance is found between local and central reviewers with regard to PET interpretation in residual tissue after intense chemotherapy. The existence of the central PET review panel allows the identification of additional patients as PET negative so that radiotherapy can be safely omitted (35 of 548 patients = 4.7%).
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Affiliation(s)
- C Kobe
- Carsten Kobe, Department of Nuclear Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany, Tel. +49/(0)221/478-50 24, Fax -67 77,
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Kriz J, Eich HT. FDG-PET bei der Involved-Node-Bestrahlung von Hodgkin-Lymphomen zur Zielvolumendefinition hilfreich. Strahlenther Onkol 2015. [DOI: 10.1007/s00066-015-0869-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bröckelmann PJ, Goergen H, Fuchs M, Kriz J, Semrau R, Baues C, Kobe C, Behringer K, Eichenauer DA, von Tresckow B, Klimm B, Halbsguth T, Wongso D, Plütschow A, Haverkamp H, Dietlein M, Eich HT, Stein H, Diehl V, Borchmann P, Engert A. Impact of centralized diagnostic review on quality of initial staging in Hodgkin lymphoma: experience of the German Hodgkin Study Group. Br J Haematol 2015; 171:547-56. [DOI: 10.1111/bjh.13646] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 07/23/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Paul J. Bröckelmann
- Department I of Internal Medicine; University Hospital of Cologne; Cologne Germany
- German Hodgkin Study Group (GHSG); Cologne Germany
| | | | - Michael Fuchs
- Department I of Internal Medicine; University Hospital of Cologne; Cologne Germany
- German Hodgkin Study Group (GHSG); Cologne Germany
| | - Jan Kriz
- German Hodgkin Study Group (GHSG); Cologne Germany
- Department of Radiation Oncology; University Hospital Münster; Münster Germany
| | - Robert Semrau
- German Hodgkin Study Group (GHSG); Cologne Germany
- Department of Radiation Oncology; University Hospital of Cologne; Cologne Germany
| | - Christian Baues
- German Hodgkin Study Group (GHSG); Cologne Germany
- Department of Radiation Oncology; University Hospital of Cologne; Cologne Germany
| | - Carsten Kobe
- German Hodgkin Study Group (GHSG); Cologne Germany
- Department of Nuclear Medicine; University Hospital of Cologne; Cologne Germany
| | - Karolin Behringer
- Department I of Internal Medicine; University Hospital of Cologne; Cologne Germany
- German Hodgkin Study Group (GHSG); Cologne Germany
| | - Dennis A. Eichenauer
- Department I of Internal Medicine; University Hospital of Cologne; Cologne Germany
- German Hodgkin Study Group (GHSG); Cologne Germany
| | - Bastian von Tresckow
- Department I of Internal Medicine; University Hospital of Cologne; Cologne Germany
- German Hodgkin Study Group (GHSG); Cologne Germany
| | - Beate Klimm
- German Hodgkin Study Group (GHSG); Cologne Germany
- Department III of Internal Medicine; Krankenhaus Düren; Düren Germany
| | - Teresa Halbsguth
- German Hodgkin Study Group (GHSG); Cologne Germany
- Department II of Internal Medicine; University Hospital of Frankfurt; Frankfurt Germany
| | - Diana Wongso
- German Hodgkin Study Group (GHSG); Cologne Germany
| | | | | | - Markus Dietlein
- German Hodgkin Study Group (GHSG); Cologne Germany
- Department of Nuclear Medicine; University Hospital of Cologne; Cologne Germany
| | - Hans T. Eich
- German Hodgkin Study Group (GHSG); Cologne Germany
- Department of Radiation Oncology; University Hospital Münster; Münster Germany
| | - Harald Stein
- German Hodgkin Study Group (GHSG); Cologne Germany
- Pathodiagnostik Berlin; Berlin Germany
| | - Volker Diehl
- German Hodgkin Study Group (GHSG); Cologne Germany
| | - Peter Borchmann
- Department I of Internal Medicine; University Hospital of Cologne; Cologne Germany
- German Hodgkin Study Group (GHSG); Cologne Germany
| | - Andreas Engert
- Department I of Internal Medicine; University Hospital of Cologne; Cologne Germany
- German Hodgkin Study Group (GHSG); Cologne Germany
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Elsayad K, Lehrich P, Yppaerilae-Wolters H, Dieckmann C, Kriz J, Haverkamp U, Eich HT. Primary Cardiac Angiosarcoma Treated With Positron Emission Tomography/Magnetic Resonance Imaging-Guided Adaptive Radiotherapy. Can J Cardiol 2015; 32:829.e7-829.e10. [PMID: 26514752 DOI: 10.1016/j.cjca.2015.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/14/2015] [Accepted: 07/14/2015] [Indexed: 10/23/2022] Open
Abstract
Radiotherapy (RT) for inoperable patients with primary cardiac sarcomas or residual tumor is often limited by the sensitivity of the heart and lung to radiation injury. We describe a novel treatment modality with adaptive radiotherapy (ART) using tumor volume tracking in a 37-year-old woman who presented with unresectable primary cardiac angiosarcoma. The patient was treated using positron emission tomography/magnetic resonance imaging-guided ART with 55.8 Gy concomitant with paclitaxel chemotherapy. In conclusion, the treatment was well tolerated, and a significant tumor volume reduction of ∼ 57% was achieved during radiotherapy, suggesting the effectiveness and tolerability of ART in combination with paclitaxel-based chemotherapy.
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Affiliation(s)
- Khaled Elsayad
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany.
| | - Philipp Lehrich
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
| | | | - Chantal Dieckmann
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
| | - Jan Kriz
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
| | - Uwe Haverkamp
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
| | - Hans Theodor Eich
- Department of Radiation Oncology, University Hospital of Muenster, Muenster, Germany
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Elsayad K, Kriz J, Bauch J, Scobioala S, Haverkamp U, Sunderkötter C, Eich HT. Radiation therapy as part of the therapeutic regimen for extensive multilocular myxedema in a patient with exophthalmos, myxedema and osteoarthropathy syndrome: A case report. Oncol Lett 2015; 9:2404-2408. [PMID: 26137080 DOI: 10.3892/ol.2015.2990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 02/13/2015] [Indexed: 01/04/2023] Open
Abstract
Exophthalmos, myxedema and osteoarthropathy (EMO) comprise the triad known as EMO syndrome, which is rarely observed in patients with autoimmune thyroid disease. The present study reports the case of a patient with EMO, including the response of this rare combination to radiotherapy. A 48-year-old patient with EMO syndrome presented to the Department of Radiation Oncology, University Hospital of Muenster, eight years prior to writing with therapy-resistant pretibial myxedema and hypertrophic osteoarthropathy of the metacarpal bones. The patient had been diagnosed with Graves' disease (GD) 26 years prior to presentation, which was treated by thyroidectomy and radioiodine therapy. Four years subsequent to the diagnosis of GD, the patient developed exophthalmos, which was treated using radiotherapy. An evident pretibial, foot and hand myxedema developed within the 10 years following the onset of orbitopathy. The skin lesions were treated using radiation therapy subsequent to the failure of multiple surgical procedures and medical treatments. Almost eight years subsequent to the administration of irradiation, no recurrence was observed on the lower right leg, nor was any recurrence on the lower left leg observed approximately four years subsequent to the completion of radiotherapy. However, an additional lesion on the left hand demonstrated slow progression following treatment with radiation therapy. The present study indicates that radiation therapy can be considered as adjuvant therapy for patients with refractory myxedema, to prevent or delay the recurrence of myxedema subsequent to surgical excision.
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Affiliation(s)
- Khaled Elsayad
- Department of Radiation Oncology, University Hospital of Muenster, Muenster D-48149, Germany
| | - Jan Kriz
- Department of Radiation Oncology, University Hospital of Muenster, Muenster D-48149, Germany
| | - Julia Bauch
- Department of Radiation Oncology, University Hospital of Muenster, Muenster D-48149, Germany
| | - Sergiu Scobioala
- Department of Radiation Oncology, University Hospital of Muenster, Muenster D-48149, Germany
| | - Uwe Haverkamp
- Department of Radiation Oncology, University Hospital of Muenster, Muenster D-48149, Germany
| | - Cord Sunderkötter
- Department of Dermatology, University Hospital of Muenster, Muenster D-48149, Germany
| | - Hans Theodor Eich
- Department of Radiation Oncology, University Hospital of Muenster, Muenster D-48149, Germany
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Kriz J, Spickermann M, Lehrich P, Schmidberger H, Reinartz G, Eich H, Haverkamp U. Breath-hold technique in conventional APPA or intensity-modulated radiotherapy for Hodgkin's lymphoma: Comparison of ILROG IS-RT and the GHSG IF-RT. Strahlenther Onkol 2015; 191:717-25. [PMID: 25876905 DOI: 10.1007/s00066-015-0839-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 03/25/2015] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The present study addresses the role of intensity-modulated radiotherapy (IMRT) in contrast to standard RT (APPA) for patients with Hodgkin's lymphoma (HL) with a focus on deep inspiration breath-hold (DIBH) technique and a comparison between the International Lymphoma Radiation Oncology Group (ILROG) Involved Site Radiotherapy (IS-RT) versus the German Hodgkin Study Group (GHSG) Involved Field Radiotherapy (IF-RT). METHODS APPA treatment and 2 IMRT plans were compared for 11 patients with HL. Furthermore, treatment with DIBH versus free breathing (FB) and two different treatment volumes, i.e. IF-RT versus IS-RT, were compared. IMRT was planned as a sliding-window technique with 5 and 7 beam angles. For each patient 12 different treatment plans were calculated (132 plans). Following organs at risk (OAR) were analysed: lung, heart, spinal cord, oesophagus, female breast and skin. Comparisons of the different values with regard to dose-volume histograms (DVH), conformity and homogeneity indices were made. RESULTS IS-RT reduces treatment volumes. With respect to the planning target volume (PTV), IMRT achieves better conformity but the same homogeneity. Regarding the D mean for the lung, IMRT shows increased doses, while RT in DIBH reduces doses. The IMRT shows improved values for Dmax concerning the spinal cord, whereas the APPA shows an improved D mean of the lung and the female breast. CONCLUSION IS-RT reduces treatment volumes. Intensity-modulated radiotherapy shows advantages in the conformity. Treatment in DIBH also reduces the dose applied to the lungs and the heart.
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Affiliation(s)
- Jan Kriz
- Department of Radiation Oncology, University of Muenster, Albert-Schweitzer Campus 1, Gebäude 1A, 48419, Muenster, Germany,
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Behringer K, Goergen H, Hitz F, Zijlstra JM, Greil R, Markova J, Sasse S, Fuchs M, Topp MS, Soekler M, Mathas S, Meissner J, Wilhelm M, Koch P, Lindemann HW, Schalk E, Semrau R, Kriz J, Vieler T, Bentz M, Lange E, Mahlberg R, Hassler A, Vogelhuber M, Hahn D, Mezger J, Krause SW, Skoetz N, Böll B, von Tresckow B, Diehl V, Hallek M, Borchmann P, Stein H, Eich H, Engert A. Omission of dacarbazine or bleomycin, or both, from the ABVD regimen in treatment of early-stage favourable Hodgkin's lymphoma (GHSG HD13): an open-label, randomised, non-inferiority trial. Lancet 2015; 385:1418-27. [PMID: 25539730 DOI: 10.1016/s0140-6736(14)61469-0] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND The role of bleomycin and dacarbazine in the ABVD regimen (ie, doxorubicin, bleomycin, vinblastine, and dacarbazine) has been questioned, especially for treatment of early-stage favourable Hodgkin's lymphoma, because of the drugs' toxicity. We aimed to investigate whether omission of either bleomycin or dacarbazine, or both, from ABVD reduced the efficacy of this regimen in treatment of Hodgkin's lymphoma. METHODS In this open-label, randomised, multicentre trial (HD13) we compared two cycles of ABVD with two cycles of the reduced-intensity regimen variants ABV (doxorubicin, bleomycin, and vinblastine), AVD (doxorubicin, vinblastine, and dacarbazine), and AV (doxorubicin and vinblastine), in patients with newly diagnosed, histologically proven, classic or nodular, lymphocyte predominant Hodgkin's lymphoma. In each treatment group, 30 Gy involved-field radiotherapy (IFRT) was given after both cycles of chemotherapy were completed. From Jan 28, 2003, patients were centrally randomly assigned (1:1:1:1) with a minimisation method to the four groups. Because of high event rates, assignment to the AV and ABV groups stopped early, on Sept 30, 2005, and Feb 10, 2006; assignment to ABVD and AVD continued (1:1) until Sept 30, 2009. Our primary objective was to show non-inferiority of the experimental variants compared with ABVD in terms of freedom from treatment failure (FFTF), by excluding a difference of 6% after 5 years corresponding to a hazard ratio (HR) of 1.72, via a 95% CI. Analyses reported here include qualified patients only, and between-group comparisons include only patients recruited during the same period. The trial was registered, number ISRCTN63474366. FINDINGS Of 1502 qualified patients, 566, 198, 571, and 167 were randomly assigned to receive ABVD, ABV, AVD, or AV, respectively. 5 year FFTF was 93.1%, 81.4%, 89.2%, and 77.1% with ABVD, ABV, AVD, and AV, respectively. Compared with ABVD, inferiority of the dacarbazine-deleted variants was detected with 5 year differences of -11.5% (95% CI -18.3 to -4.7; HR 2.06 [1.21 to 3.52]) for ABV and -15.2% (-23.0 to -7.4; HR 2.57 [1.51 to 4.40]) for AV. Non-inferiority of AVD compared with ABVD could also not be detected (5 year difference -3.9%, -7.7 to -0·1; HR 1.50, 1.00 to 2.26). 178 (33%) of 544 patients given ABVD had WHO grade III or IV toxicity, compared with 53 (28%) of 187 given ABV, 142 (26%) of 539 given AVD, and 40 (26%) of 151 given AV. Leucopenia was the most common event, and highest in the groups given bleomycin. INTERPRETATION Dacarbazine cannot be omitted from ABVD without a substantial loss of efficacy. With respect to our predefined non-inferiority margin, bleomycin cannot be safely omitted either, and the standard of care for patients with early-stage favourable Hodgkin's lymphoma should remain ABVD followed by IFRT. FUNDING Deutsche Krebshilfe and Swiss State Secretariat for Education and Research.
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Affiliation(s)
- Karolin Behringer
- German Hodgkin Study Group (GHSG), Department of Internal Medicine 1, University Hospital of Cologne, Cologne, Germany
| | - Helen Goergen
- German Hodgkin Study Group (GHSG), Department of Internal Medicine 1, University Hospital of Cologne, Cologne, Germany
| | - Felicitas Hitz
- Cantonal Hospital of St Gallen, St Gallen, Switzerland and SAKK Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | | | - Richard Greil
- Third Medical Department, Paracelcus Medical University, Salzburg, Austria
| | - Jana Markova
- University Hospital Kralovske Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Stephanie Sasse
- German Hodgkin Study Group (GHSG), Department of Internal Medicine 1, University Hospital of Cologne, Cologne, Germany
| | - Michael Fuchs
- German Hodgkin Study Group (GHSG), Department of Internal Medicine 1, University Hospital of Cologne, Cologne, Germany
| | - Max S Topp
- University Hospital Würzburg, Würzburg, Germany
| | | | - Stephan Mathas
- Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany
| | | | | | - Peter Koch
- University Hospital Münster, Münster, Germany
| | | | - Enrico Schalk
- Department of Haematology and Oncology, Medical Centre, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Robert Semrau
- Department of Radiation Oncology, University Hospital of Cologne, Cologne, Germany
| | - Jan Kriz
- University Hospital Münster, Münster, Germany
| | - Tom Vieler
- Medizinische Klinik, Universitätsklinik Schleswig-Holstein, Kiel, Germany
| | - Martin Bentz
- Medizinische Klinik, Städtisches Klinikum Karlsruhe, Germany
| | - Elisabeth Lange
- Medizinische Klinik, Hämatologie/Onkologie, Evangelisches Krankenhaus, Hamm, Germany
| | - Rolf Mahlberg
- Medizinische Klinik, Krankenanstalt Mutterhaus d. Borromäerinnen, Trier, Germany
| | - Andre Hassler
- Zentrum für Innere Medizin, Hämatologie/Onkologie, Charité Campus Mitte, Berlin, Germany
| | - Martin Vogelhuber
- Medizinische Klinik, Universitätsklinik Regensburg, Regensburg, Germany
| | - Dennis Hahn
- Klinik für Onkologie, Katharinenhospital, Stuttgart, Germany
| | - Jörg Mezger
- Medizinische Klinik-Hämatologie, Onkologie, Immunologie, Palliativmedizin, St. Vincentius-Kliniken gAG, Karlsruhe, Germany
| | - Stefan W Krause
- Department of Internal Medicine 5, Haematology/Oncology, University of Erlangen, Germany
| | - Nicole Skoetz
- Cochrane Haematological Malignancies Group, Department of Internal Medicine 1, University Hospital of Cologne, Cologne, Germany
| | - Boris Böll
- German Hodgkin Study Group (GHSG), Department of Internal Medicine 1, University Hospital of Cologne, Cologne, Germany
| | - Bastian von Tresckow
- German Hodgkin Study Group (GHSG), Department of Internal Medicine 1, University Hospital of Cologne, Cologne, Germany
| | - Volker Diehl
- German Hodgkin Study Group (GHSG), Department of Internal Medicine 1, University Hospital of Cologne, Cologne, Germany
| | - Michael Hallek
- Department of Internal Medicine 1, University Hospital of Cologne, Cologne, Germany
| | - Peter Borchmann
- German Hodgkin Study Group (GHSG), Department of Internal Medicine 1, University Hospital of Cologne, Cologne, Germany
| | - Harald Stein
- Berlin Reference Center for Lymphoma and Haematopathology, Berlin, Germany
| | - Hans Eich
- University Hospital Münster, Münster, Germany
| | - Andreas Engert
- German Hodgkin Study Group (GHSG), Department of Internal Medicine 1, University Hospital of Cologne, Cologne, Germany.
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Muecke R, Micke O, Schomburg L, Kisters K, Buentzel J, Huebner J, Kriz J. Selenium supplementation in radiotherapy patients: do we need to measure selenium levels in serum or blood regularly prior radiotherapy? Radiat Oncol 2014; 9:289. [PMID: 25511764 PMCID: PMC4272541 DOI: 10.1186/s13014-014-0289-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 12/04/2014] [Indexed: 01/15/2023] Open
Abstract
Considering the review by Puspitasari and colleagues, an additional discussion of the endpoints of the Se supplementation studies described would be helpful. In our view, selenium can safely be given to selenium-deficient cancer patients prior to and during radiotherapy. Therefore, in order to help the radiation oncologist in decision making, we strongly advocate to determine the selenium status prior to and during a potential adjuvant selenium supplementation, e.g. when trying to ease the side-effects of radiation treatment or in the aftercare situation when the selenium status may become insufficient.
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Affiliation(s)
- Ralph Muecke
- Department of Radiotherapy, Lippe Hospital Lemgo, Rintelner Str. 85, D-32657, Lemgo, Germany. .,Department of Radiotherapy and Radiation Oncology, Ruhr University Bochum, Bochum, Germany.
| | - Oliver Micke
- Department of Radiotherapy and Radiation Oncology, Franziskus Hospital, Bielefeld, Germany.
| | - Lutz Schomburg
- Institute for Experimental Endocrinology, Charité Berlin, Germany.
| | - Klaus Kisters
- Department of Internal Medicine, St. Anna Hospital, Herne, Germany.
| | - Jens Buentzel
- Department of Otolaryngology, Südharz Hospital, Nordhausen, Germany.
| | - Jutta Huebner
- Working Group Integrative Oncology, German Cancer Society, Berlin, Germany.
| | - Jan Kriz
- Department of Radiotherapy and Radiation Oncology, Münster University Hospital, Münster, Germany.
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Spickermann M, Kriz J, Haverkamp U, Frick S, Eich H. How Reliable Is Cone Beam Computed Tomography (CBCT)?: A Quality Control of Intensity Modulated Radiation Therapy and Intensity Modulated Arc Therapy for Patients With Hodgkin Lymphoma. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fabryova E, Jirak D, Girman P, Zacharovova K, Galisova A, Saudek F, Kriz J. Effect of Mesenchymal Stem Cells on the Vascularization of the Artificial Site for Islet Transplantation in Rats. Transplant Proc 2014; 46:1963-6. [DOI: 10.1016/j.transproceed.2014.05.074] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Haverkamp U, Norkus D, Kriz J, Müller Minai M, Prott FJ, Eich HT. Optimization by visualization of indices. Strahlenther Onkol 2014; 190:1053-9. [PMID: 24972890 DOI: 10.1007/s00066-014-0688-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 05/13/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE Physical 3D treatment planning provides a pool of parameters describing dose distributions. It is often useful to define conformal indices to enable quicker evaluation. However, the application of individual indices is controversial and not always effective. The aim of this study was to design a quick check of dose distributions based on several indices detecting underdosages within planning target volumes (PTVs) and overdosages in normal tissue. MATERIALS AND METHODS Dose distributions of 215 cancer patients were considered. Treatment modalities used were three-dimensional conformal radiotherapy (3DCRT), radiosurgery, intensity-modulated radiotherapy (IMRT), intensity-modulated arc therapy (IMAT) and tomotherapy. The volumes recommended in ICRU 50 and 83 were used for planning and six conformation and homogeneity indices were selected: CI, CN, CICRU, COV, C∆, and HI. These were based on the PTV, the partial volume covered by the prescribed isodose (PI; PTVPI), the treated volume (TVPI), near maximum D2 and near minimum D98. Results were presented as a hexagon-the corners of which represent the values of the indices-and a modified test function F (Rosenbrock's function) was calculated. Results refer to clinical examples and mean values, in order to allow evaluation of the power of F and hexagon-based decision support procedures in detail and in general. RESULTS IMAT and tomotherapy showed the best values for the indices and the lowest standard deviation followed by static IMRT. DCRT and radiosurgery (e.g. CN: IMAT 0.85 ± 0.06; tomotherapy 0.84 ± 0.06; IMRT 0.83 ± 0.07; 3DCRT 0.65 ± 0.08; radiosurgery 0.64 ± 0.11). In extreme situations, not all indices reflected the situation correctly. Over- and underdosing of PTV and normal tissue could be qualitatively assessed from the distortion of the hexagon in graphic analysis. Tomotherapy, IMRT, IMAT, 3DCRT and radiosurgery showed increasingly distorted hexagons, the type of distortion indicating exposure of normal tissue volumes. The calculated F values correlated with these observations. CONCLUSION An evaluation of dose distributions cannot be based on a single conformal index. A solution could be the use of several indices presented as a hexagonal graphic and/or as a test function.
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Affiliation(s)
- Uwe Haverkamp
- Department of Radiotherapy, University Muenster, Albert-Schweitzer-Campus 1, 48129, Münster, Germany,
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Kriz J, Eich HT, Haverkamp U, Seegenschmiedt MH, Heide J, Bruns F, Micke O. Radiotherapy is effective for desmoid tumors (aggressive fibromatosis) - long-term results of a German multicenter study. Oncol Res Treat 2014; 37:255-60. [PMID: 24853785 DOI: 10.1159/000362398] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 03/13/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Desmoids (aggressive fibromatosis) are defined as benign neoplasms of the connective tissue that arise from the deep muscle fascia, aponeurosis, tendons, and scar tissue. Recurrence rates between 40 and 80% were reported after surgery alone. We addressed the impact of radiation therapy (RT) in the management of aggressive fibromatosis. PATIENTS AND METHODS A large literature review was performed, and the data was compared with the results of a multicenter study of the German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD). RESULTS This analysis included 52 patients treated with RT. 37 patients received postoperative RT (20 patients after R2 resection and 17 patients after R1 resection). 15 patients received RT alone (6 patients with inoperable primary tumor and 9 patients with inoperable recurrent tumor). In the case of postoperative RT, a median dose of 50 Gy (range 50-60 Gy) was used; for definitive RT, a median dose of 55 Gy (range 55-65 Gy) was used. The local control rate was 79% for the whole group. The median follow-up was 44 month (range 8-62 months). CONCLUSION Given the large number of patients, these data show that RT is highly effective in the treatment of desmoid tumors. RT is an attractive alternative to mutilating surgery.
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Affiliation(s)
- Jan Kriz
- Klinik und Poliklinik für Strahlentherapie - Radioonkologie, Universitätsklinikum Münster, Münster, Germany
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Kobe C, Dietlein M, Kriz J, Furth C, Fuchs M, Borchmann P, Engert A, Eich HT. The role of PET in Hodgkin’s lymphoma and its impact on radiation oncology. Expert Rev Anticancer Ther 2014; 10:1419-28. [DOI: 10.1586/era.10.114] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Wißmann N, Dirksen D, Suwelack D, Kriz J, Runte C, Eich H, Haverkamp U. EP-1489: Additional exposure by backscattering at high density dental prosthetics in the radiotherapy. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31607-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kriz J, Eich HT, Bruns F, Heyd R, Schäfer U, Haverkamp U, Büntzel J, Seegenschmiedt H, Micke O. Radiotherapy in langerhans cell histiocytosis - a rare indication in a rare disease. Radiat Oncol 2013; 8:233. [PMID: 24103738 PMCID: PMC3852286 DOI: 10.1186/1748-717x-8-233] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 10/05/2013] [Indexed: 11/10/2022] Open
Abstract
Introduction Langerhans Cell Histiocytosis (LCH) represents a rare benign disorder, previously designated as “Histiocytosis X”, “Type II Histiocytosis” or “Langerhans Cell Granulomatosis”. Clinical presentation includes osteolysis, ulcerations of skin and soft tissues but also involvement of the CNS is described. Because treatment concepts are not well defined the German Cooperative Group on Radiotherapy for Benign Diseases performed a retrospective analysis. Methods and material Eight closely cooperating centres collected patients’ data of the past 45 years. As study endpoints disease free survival, recurrent disease, death and therapy related side effects were defined. Results A total of 80 patients with histologically proven LCH were irradiated within the past 45 years. According to the LCH classification of Greenberger et al. 37 patients had stage Ia, 21 patients stage Ib, 13 patients stage II and 9 patients stage IIIb and the median age was 29 years. The median Follow up was 54 months (range 9–134 months). A total of 39 patients had a surgical intervention and 23 patients a chemotherapy regimen. Radiation treatment was carried out with a median total dose of 15 Gy (range 3–50.4 Gy). The median single fraction was 2 Gy (range 1.8-3 Gy). Overall, 77% patients achieved a complete remission and 12.5% achieved a partial remission. The long-term control rate reached 80%. Within an actuarial overall 5-year survival of 90% no radiogenic side and late effects ≥EORTC/RTOG II° were observed. Conclusion In the present study a large collective of irradiated patients was analysed. Radiotherapy (RT) is a very effective and safe treatment option and even low RT doses show sufficient local control.
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Affiliation(s)
- Jan Kriz
- Klinik für Strahlentherapie und Radioonkologie, Franziskus Hospital, Bielefeld, Germany.
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Eich H, Kriz J, Reinartz G, Kobe C, Kuhnert G, Haverkamp U, Haverkamp H, Hegerfeld K, Baues C, Engert A. Relapse Analysis After Radiation Therapy of PET-Positive Residual Tumors of Patients With Advanced Stage Hodgkin Lymphoma Treated in the HD15 Trial of the German Hodgkin Study Group (GHSG). Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Eich HT, Kriz J. Role of Radiological Imaging in Radiation Oncology: Experiences within the German Hodgkin Study Group (GHSG). ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1345805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Eich HT, Kriz J, Schmidberger H, Böll B, Klimm B, Rancea M, Müller RP, Engert A. The German evidence-based guidelines for Hodgkin's lymphoma. Aspects for radiation oncologists. Strahlenther Onkol 2013; 189:445-7. [PMID: 23604187 DOI: 10.1007/s00066-013-0331-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 02/13/2013] [Indexed: 11/29/2022]
Abstract
This report reviews aspects of the German evidence-based guidelines for Hodgkin's lymphoma relevant to radiation oncologists. Stage-adapted treatment is discussed with the focus on radiotherapy. Up-to-date literature citations provide an overview of current recommendations.
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Affiliation(s)
- H T Eich
- Department of Radiation Oncology, University of Muenster, Albert-Schweitzer-Campus 1, Münster, Germany.
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Eich H, Kriz J, Klimm B, Sasse S, Görgen H, Diehl V, Borchmann P, Mueller R, Engert A. Involved-field (IF) Versus Extended-field (EF) Radiation Therapy (RT) for Patients in Early Unfavorable Stages of Hodgkin Lymphoma: 10-year Update of the HD8 Trial of the German Hodgkin Study Group (GHSG). Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kriz J, Mueller RP, Mueller H, Kuhnert G, Engert A, Kobe C, Haverkamp U, Eich H. Large mediastinal tumor mass as a prognostic factor in Hodgkin’s lymphoma. Strahlenther Onkol 2012; 188:1020-4. [DOI: 10.1007/s00066-012-0163-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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