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Gani C, Polat B, Ott O, Germer E, Königsrainer A, Kirschniak A, Clasen S, Grosse U, Diefenhardt M, Bitzer M, Reibetanz J, Martus P, Flentje M, Fietkau R, Fokas E, Zips D, Rödel C. OC-0833 Total neoadjuvant therapy for Organ Preservation in Rectal Cancer: The CAO/ARO/AIO-16 phase II trial. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02697-4] [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: 10/18/2022]
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Zimmermann M, Zenk M, Breuer K, Schwab F, Ströhle S, Pemsel F, Keßler P, Greber J, Flentje M, Polat B. PO-1231 Deep inspiration breath-hold in breast cancer radiotherapy using a laser beam based gating system. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03195-4] [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: 10/18/2022]
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Schmid S, Schiller K, Seitz A, Koll F, Beckert F, Korn P, Lewerich J, Maisch P, Sauter A, Rödel C, Flentje M, Riedel T, Combs S, Zengerling F, Bolenz C, Kübler H, Gschwend J, Retz M. RACE IT - A prospective, single arm, multicenter, phase II-trial to assess safety and efficacy of preoperative RAdiation therapy before radical CystEctomy combined with ImmunoTherapy in locally advanced urothelial carcinoma of the bladder (AB 65/18). Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00417-1] [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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Fokas E, Schlenska-Lange A, Polat B, Klautke G, Fietkau R, Kuhnt T, Brunner T, Grosu A, Kirste S, Flentje M, Germer C, Bechstein W, Friede T, Hofheinz R, Ghadimi M, Rödel C. OC-0293 TNT in rectal cancer: Final results of the CAO/ARO/AIO-12 randomized phase 2 trial. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06841-9] [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: 10/20/2022]
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Lewitzki V, Wegener S, Toussaint A, Flentje M, Pollmann S. PO-1635 Dosimetric characterization of patient-specific three-dimensional tissue-equivalent bolus. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08086-5] [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: 10/20/2022]
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Polat B, Binder L, Exner F, Kessler P, Flentje M, Bratengeier K. PO-1831 Reducing the source axis distance to 80 cm - a prostate cancer planning study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08282-7] [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: 10/20/2022]
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Flentje M, Hagemann V, Breuer G, Bintaro P, Eismann H. Change of collective orientation through an interprofessional training with medical students and student nurses depending on presence and professional group. BMC Med Educ 2021; 21:365. [PMID: 34217272 PMCID: PMC8254984 DOI: 10.1186/s12909-021-02804-7] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/24/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Teamwork is an important success factors for patient treatment. The willingness of a healthcare provider to work in a team can be descripted with the construct of "Collective Orientation" (CO). The level of CO can be trained and is related to team performance. In this study, we investigated the effect of a simulator-based interprofessional training on the subject of patient fall in a hospital setting upon participations CO. To evaluate whether the course could be integrated into a longitudinal education concept, the participants were medical students and student nurses. Since effects of simulations can be influenced by the perceived reality, the results were measured as a function of Presence. METHOD In this observation study, 62 medical students and student nurses took part in six one-day interprofessional simulation trainings with the topic patient fall. The primary outcome was the mean difference between the CO measured immediately before (T1) and after the training (T2). The Presence of the participants was measured by questionnaire immediately after the course (T2). RESULTS Cronbach´s alpha for all scales and measurement points was higher than 0.69. CO increases over all professional groups from M = 3.42 (SD = 0.39) to M = 3.68 (SD = 0.54) significantly (p < .00; r = .5). Only the subscale "Dominance" in the professional group of the student nurses did not increase significantly. There was no correlation between Presence and the change in CO. CONCLUSION The questionnaires of CO and Presence can be applied to medical students and student nurses. The simulation course with the topic patient fall influences the CO and can be integrated in a longitudinal curriculum of teamwork training. The subscale "Dominance" of student nurses did not change. Preparatory learning units may increase the effects. The perceived reality of the scenario is not a main success factor.
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Affiliation(s)
- M Flentje
- Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Carl- Neuberg-Strasse 1, 30625, Hannover, Germany.
| | - V Hagemann
- Faculty of Business Studies and Economics, University of Bremen, Enrique-Schmidt-Strasse 1, 28359, Bremen, Germany
| | - G Breuer
- Department of Anaesthesiology, REGIOMED Kliniken, Ketschendorfer Strasse 33, 96450, Coburg, Germany
| | - P Bintaro
- Department of Nephrology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
| | - H Eismann
- Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Carl- Neuberg-Strasse 1, 30625, Hannover, Germany
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Kohls F, Gebauer F, Brodowski L, Flentje M, von Kaisenberg C, Jentschke M. Aktuelle Praxis der Äußeren Wendung in Deutschland. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717921] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- F Kohls
- Medizinische Hochschule Hannover, Frauenklinik
| | - F Gebauer
- Medizinische Hochschule Hannover, Frauenklinik
| | - L Brodowski
- Medizinische Hochschule Hannover, Frauenklinik
| | - M Flentje
- Medizinische Hochschule Hannover, Anästhesiologie und Intensivmedizin
| | | | - M Jentschke
- Medizinische Hochschule Hannover, Frauenklinik
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Dietz A, Wichmann G, Kuhnt T, Pfreundner L, Hagen R, Scheich M, Kölbl O, Hautmann MG, Strutz J, Schreiber F, Bockmühl U, Schilling V, Feyer P, de Wit M, Maschmeyer G, Jungehülsing M, Schroeder U, Wollenberg B, Sittel C, Münter M, Lenarz T, Klussmann JP, Guntinas-Lichius O, Rudack C, Eich HT, Foerg T, Preyer S, Westhofen M, Welkoborsky HJ, Esser D, Thurnher D, Remmert S, Sudhoff H, Görner M, Bünzel J, Budach V, Held S, Knödler M, Lordick F, Wiegand S, Vogel K, Boehm A, Flentje M, Keilholz U. Induction chemotherapy (IC) followed by radiotherapy (RT) versus cetuximab plus IC and RT in advanced laryngeal/hypopharyngeal cancer resectable only by total laryngectomy-final results of the larynx organ preservation trial DeLOS-II. Ann Oncol 2019; 29:2105-2114. [PMID: 30412221 DOI: 10.1093/annonc/mdy332] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The German multicenter randomized phase II larynx organ preservation (LOP) trial DeLOS-II was carried out to prove the hypothesis that cetuximab (E) added to induction chemotherapy (IC) and radiotherapy improves laryngectomy-free survival (LFS; survival with preserved larynx) in locally advanced laryngeal/hypopharyngeal cancer (LHSCC). Patients and methods Treatment-naïve patients with stage III/IV LHSCC amenable to total laryngectomy (TL) were randomized to three cycles IC with TPF [docetaxel (T) and cisplatin (P) 75 mg/m2/day 1, 5-FU (F) 750 mg/m2/day days 1-5] followed by radiotherapy (69.6 Gy) without (A) or with (B) standard dose cetuximab for 16 weeks throughout IC and radiotherapy (TPFE). Response to first IC-cycle (IC-1) with ≥30% endoscopically estimated tumor surface shrinkage (ETSS) was used to define early responders; early salvage TL was recommended to non-responders. The primary objective was 24 months LFS above 35% in arm B. Results Of 180 patients randomized (July 2007 to September 2012), 173 fulfilled eligibility criteria (A/B: larynx 44/42, hypopharynx 41/46). Because of 4 therapy-related deaths among the first 64 randomized patients, 5-FU was omitted from IC in the subsequent 112 patients reducing further fatal toxicities. Thus, IC was TPF in 61 patients and TP in 112 patients, respectively. The primary objective (24 months LFS above 35%) was equally met by arms A (40/85, 47.1%) as well as B (41/88, 46.6%). One hundred and twenty-three early responders completed IC+RT; their overall response rates (TPF/TP) were 94.7%/87.2% in A versus 80%/86.0% in B. The 24 months overall survival (OS) rates were 68.2% and 69.3%. Conclusions Despite being accompanied by an elevated frequency in adverse events, the IC with TPF/TP plus cetuximab was feasible but showed no superiority to IC with TPF/TP regarding LFS and OS at 24 months. Both early response and 24 months LFS compare very well to previous LOP trials and recommend effective treatment selection and stratification by ETSS. Clinical trial information NCT00508664.
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Affiliation(s)
- A Dietz
- Department of Otolaryngology, Head and Neck Surgery, University Leipzig, Leipzig, Germany.
| | - G Wichmann
- Department of Otolaryngology, Head and Neck Surgery, University Leipzig, Leipzig, Germany
| | - T Kuhnt
- Department of Radiation Oncology, University Leipzig, Leipzig, Germany
| | - L Pfreundner
- Department of Radiation Oncology, University Würzburg, Würzburg, Germany
| | - R Hagen
- Department of Otolaryngology, Head and Neck Surgery, University Würzburg, Würzburg, Germany
| | - M Scheich
- Department of Otolaryngology, Head and Neck Surgery, University Würzburg, Würzburg, Germany
| | - O Kölbl
- Department of Radiation Oncology, University Regensburg, Regensburg, Germany
| | - M G Hautmann
- Department of Radiation Oncology, University Regensburg, Regensburg, Germany
| | - J Strutz
- Department of Otolaryngology, Head and Neck Surgery, University Regensburg, Regensburg, Germany
| | - F Schreiber
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Kassel, Kassel, Germany
| | - U Bockmühl
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Kassel, Kassel, Germany
| | - V Schilling
- Department of Otolaryngology, Head and Neck Surgery, Vivantes, Berlin, Neukölln, Germany
| | - P Feyer
- Department of Radiation Oncology, Vivantes, Berlin, Neukölln, Germany
| | - M de Wit
- Department of Hemato-Oncology, Vivantes, Berlin, Neukölln, Germany
| | - G Maschmeyer
- Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Potsdam, Germany
| | - M Jungehülsing
- Department of Otolaryngology, Head and Neck Surgery, Potsdam Klinikum, Potsdam, Germany
| | - U Schroeder
- Department of Otolaryngology, Head and Neck Surgery, University Lübeck, Lübeck, Germany
| | - B Wollenberg
- Department of Otolaryngology, Head and Neck Surgery, University Lübeck, Lübeck, Germany
| | - C Sittel
- Department of Otolaryngology, Head and Neck Surgery, Katharinen Hospital, Stuttgart, Germany
| | - M Münter
- Department of Radiation Oncology, Katharinen Hospital, Stuttgart, Germany
| | - T Lenarz
- Department of Otolaryngology, Head and Neck Surgery, MHH Hannover, Hannover, Germany
| | - J P Klussmann
- Department of Otolaryngology, Head and Neck Surgery, University Gießen, Gießen, Germany
| | - O Guntinas-Lichius
- Department of Otolaryngology, Head and Neck Surgery, Jena University Hospital, Jena, Germany
| | - C Rudack
- Department of Otolaryngology, Head and Neck Surgery, University Münster, Münster, Germany
| | - H T Eich
- Department of Radiation Oncology, University Münster, Münster, Germany
| | - T Foerg
- Department of Radiation Oncology, Head and Neck Surgery, St. Vincentius, ViDia Christliche Kliniken Karlsruhe, Karlsruhe, Germany
| | - S Preyer
- Department of Otolaryngology, Head and Neck Surgery, St. Vincentius, ViDia Christliche Kliniken Karlsruhe, Karlsruhe, Germany
| | - M Westhofen
- Department of Otolaryngology, Head and Neck Surgery, University Aachen, Aachen, Germany
| | - H J Welkoborsky
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Nordstadt, Hannover, Germany
| | - D Esser
- Department of Otolaryngology, Head and Neck Surgery, Helios Klinikum, Erfurt, Germany
| | - D Thurnher
- Department of Otolaryngology, Head and Neck Surgery, University Graz, Graz, Austria
| | - S Remmert
- Department of Otolaryngology, Head and Neck Surgery, Malteser Hospital Duisburg, Duisburg, Germany
| | - H Sudhoff
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Bielefeld, Bielefeld, Germany
| | - M Görner
- Department of Hemato-Oncology, Klinikum Bielefeld, Bielefeld, Germany
| | - J Bünzel
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Nordhausen, Nordhausen, Germany
| | - V Budach
- Department of Radiation Oncology, CCC, Charité-University Medicine, Berlin, Germany
| | - S Held
- ClinAssess GmbH, Leverkusen, Germany
| | - M Knödler
- Department of Oncology, University Cancer Center Leipzig (UCCL), Leipzig, Germany
| | - F Lordick
- Department of Oncology, University Cancer Center Leipzig (UCCL), Leipzig, Germany
| | - S Wiegand
- Department of Otolaryngology, Head and Neck Surgery, University Leipzig, Leipzig, Germany
| | - K Vogel
- Department of Otolaryngology, Head and Neck Surgery, University Leipzig, Leipzig, Germany
| | - A Boehm
- Department of Otolaryngology, Head and Neck Surgery, St. Georg Hospital Leipzig, Leipzig, Germany
| | - M Flentje
- Department of Radiation Oncology, University Würzburg, Würzburg, Germany
| | - U Keilholz
- Charité Comprehensive Cancer Center, Berlin, Germany
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Eismann H, Enke K, Scheinichen F, Böhmelt D, Flentje M. Evaluation der Notfallsanitäterprüfung in Niedersachsen. Notf Rett Med 2019. [DOI: 10.1007/s10049-018-0564-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: 11/29/2022]
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Kosmala R, Fokas E, Flentje M, Sauer R, Liersch T, Graeven U, Fietkau R, Hohenberger W, Arnold D, Hofheinz R, Ghadimi M, Raab H, Ströbel P, Staib L, Grabenbauer G, Folprecht G, Uter W, Gall C, Rödel C, Polat B. OC-0384 QoL after multimodal treatment of rectal cancer with/without oxaliplatin (phase 3, CAO/ARO/AIO-04). Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30804-7] [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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Zimmermann M, Weick S, Exner F, Richter A, Flentje M, Polat B. EP-1458 Acute toxicities comparing VMAT versus 3DCRT in locally advanced rectal cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31878-x] [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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Hass HG, Seywald M, Wöckel A, Flentje M, Weigel M, Beckmann MW, Kunzmann V. Clinical and histopathological differences between premenopausal and postmenopausal ER+ breast cancer. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671526] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- HG Hass
- Paracelsus-Klinik, Scheidegg, Deutschland
- Praxis für Onkologie und Hämatologie Westallgäu, Scheidegg, Deutschland
| | - M Seywald
- Paracelsus-Klinik, Scheidegg, Deutschland
| | - A Wöckel
- Frauenklinik Universität Würzburg, Würzburg, Deutschland
| | - M Flentje
- Klinik und Poliklinik für Strahlentherapie, Universität Würzburg, Würzburg, Deutschland
| | - M Weigel
- Frauenklinik Leopoldina, Schweinfurt, Deutschland
| | - MW Beckmann
- Frauenklinik Universität Erlangen, Erlangen, Deutschland
| | - V Kunzmann
- Medizinische Klinik und Poliklinik 2, Universität Würzburg, Würzburg, Deutschland
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Hass HG, Seywald M, Wöckel A, Flentje M, Weigel M, Beckmann MW, Kunzmann V. Prognostic value of Ki67 labelling index in different subtypes of invasive breast cancer. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671527] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- HG Hass
- Paracelsus-Klinik, Scheidegg, Deutschland
- Praxis für Onkologie und Hämatologie Westallgäu, Scheidegg, Deutschland
| | - M Seywald
- Paracelsus-Klinik, Scheidegg, Deutschland
| | - A Wöckel
- Frauenklinik Universität Würzburg, Würzburg, Deutschland
| | - M Flentje
- Klinik und Poliklinik für Strahlentherapie, Universität Würzburg, Würzburg, Deutschland
| | - M Weigel
- Frauenklinik Leopoldina, Schweinfurt, Deutschland
| | - MW Beckmann
- Frauenklinik Universität Erlangen, Erlangen, Deutschland
| | - V Kunzmann
- Medizinische Klinik und Poliklinik 2, Universität Würzburg, Würzburg, Deutschland
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Hass HG, Seywald M, Wöckel A, Flentje M, Weigel M, Beckmann MW, Kunzmann V. Early and late Toxicity and side effects with relevance for social medicine in patients with breast cancer – Time-dependent analysis of 5800 breast cancer patients. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671648] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- HG Hass
- Paracelsus-Klinik, Scheidegg, Deutschland
- Praxis für Onkologie und Hämatologie Westallgäu, Scheidegg, Deutschland
| | - M Seywald
- Paracelsus-Klinik, Scheidegg, Deutschland
| | - A Wöckel
- Frauenklinik Universität Würzburg, Würzburg, Deutschland
| | - M Flentje
- Klinik und Poliklinik für Strahlentherapie, Universität Würzburg, Würzburg, Deutschland
| | - M Weigel
- Frauenklinik Leopoldina, Schweinfurt, Deutschland
| | - MW Beckmann
- Frauenklinik Universität Erlangen, Erlangen, Deutschland
| | - V Kunzmann
- Medizinische Klinik und Poliklinik 2, Universität Würzburg, Würzburg, Deutschland
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Flentje M, Block M, Sieg L, Seebode R, Eismann H. Erweiterte Maßnahmen und interprofessionelle Konflikte nach Einführung des Berufsbildes Notfallsanitäter. Notf Rett Med 2018. [DOI: 10.1007/s10049-018-0419-6] [Citation(s) in RCA: 3] [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: 10/18/2022]
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Klement R, Hoerner-Rieber J, Adebahr S, Andratschke N, Blanck O, Boda-Heggemann J, Duma M, Eble M, Eich H, Flentje M, Gerum S, Hass P, Henkenberens C, Hildebrandt G, Imhoff D, Kahl K, Klass N, Krempien R, Lohaus F, Petersen C, Schrade E, Wendt T, Wittig A, Guckenberger M. Stereotactic body radiotherapy (SBRT) for multiple pulmonary oligometastases: Analysis of number and timing of repeat SBRT as impact factors on treatment safety and efficacy. Radiother Oncol 2018; 127:246-252. [DOI: 10.1016/j.radonc.2018.02.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/14/2018] [Accepted: 02/15/2018] [Indexed: 12/25/2022]
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Polat B, Feuerbach I, Kerscher A, Wiegering A, Flentje M. EP-1490: Radiotherapy for the primary tumor in metastatic rectal cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31799-7] [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: 10/14/2022]
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Hörner-Rieber J, Abbasi-Senger N, Blanck O, Boda-Heggemann J, Duma M, Eble M, Eich H, Flentje M, Gerum S, Haas P, Henkenberens C, Imhoff D, Kahl H, Klass N, Krempien R, Lohaus F, Petersen C, Sackerer I, Schrade E, Uhlmann L, Wittig A, Guckenberger M. PV-0043: Histology as predictor for outcome following SBRT in NSCLC patients with lung oligo-metastases. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30353-0] [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: 11/26/2022]
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Guckenberger M, Sweeney R, Hawkins M, Belderbos J, Andratschke N, Ahmed M, Madani I, Mantel F, Steigerwald S, Flentje M. PV-0475: Stereotactic Body Radiation Therapy For Painful Spinal Metastases - Results Of A Phase 2 Study. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30785-0] [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: 11/15/2022]
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Guckenberger M, Klement R, Rieber J, Adebahr S, Andratschke N, Blanck O, Boda-Heggemann J, Duma M, Eble M, Eich H, Flentje M, Gerum S, Haas P, Henkenberens C, Hildebrandt G, Imhoff D, Kahl H, Klass N, Krempien R, Lohaus F, Petersen C, Schrade E, Wendt T, Wittig A. PV-0044: Repeat sbrt for pulmonary oligo-metastases. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30354-2] [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: 10/14/2022]
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Tanadini-Lang S, Rieber J, Filippi AR, Fode MM, Streblow J, Adebahr S, Andratschke N, Blanck O, Boda-Heggemann J, Duma M, Eble MJ, Ernst I, Flentje M, Gerum S, Hass P, Henkenberens C, Hildebrandt G, Imhoff D, Kahl H, Klass ND, Krempien R, Lohaus F, Petersen C, Schrade E, Wendt TG, Wittig A, Høyer M, Ricardi U, Sterzing F, Guckenberger M. Nomogram based overall survival prediction in stereotactic body radiotherapy for oligo-metastatic lung disease. Radiother Oncol 2017; 123:182-188. [PMID: 28169042 DOI: 10.1016/j.radonc.2017.01.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 12/28/2016] [Accepted: 01/03/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Radical local treatment of pulmonary metastases is practiced with increasing frequency due to acknowledgment and better understanding of oligo-metastatic disease. This study aimed to develop a nomogram predicting overall survival (OS) after stereotactic body radiotherapy (SBRT) for pulmonary metastases. PATIENTS AND METHODS A multi-institutional database of 670 patients treated with SBRT for pulmonary metastases was used as training cohort. Cox regression analysis with bidirectional variable elimination was performed to identify factors to be included into the nomogram model to predict 2-year OS. The calibration rate of the nomogram was assessed by plotting the actual Kaplan-Meier 2-year OS against the nomogram predicted survival. The nomogram was externally validated using two separate monocentric databases of 145 and 92 patients treated with SBRT for pulmonary metastases. RESULTS The median follow up of the trainings cohort was 14.3months, the 2-year and 5-year OS was 52.6% and 23.7%, respectively. Karnofsky performance index, type of the primary tumor, control of the primary tumor, maximum diameter of the largest treated metastasis and number of metastases (1 versus >1) were significant prognostic factors in the Cox model (all p<0.05). The calculated concordance-index for the nomogram was 0.73 (concordance indexes of all prognostic factors between 0.54 and 0.6). Based on the nomogram the training cohort was divided into 4 groups and 2-year OS ranged between 24.2% and 76.1% (predicted OS between 30.2% and 78.4%). The nomogram discriminated between risk groups in the two validation cohorts (concordance index 0.68 and 0.67). CONCLUSIONS A nomogram for prediction of OS after SBRT for pulmonary metastases was generated and externally validated. This tool might be helpful for interdisciplinary discussion and evaluation of local and systemic treatment options in the oligo-metastatic setting. KEY MESSAGE A nomogram for prediction of overall survival after stereotactic body radiotherapy (SBRT) for pulmonary metastases was developed and externally validated. This tool might be helpful for interdisciplinary discussion and evaluation of local and systemic treatment options in the oligo-metastatic setting.
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Affiliation(s)
- S Tanadini-Lang
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland
| | - J Rieber
- Department of Radiation Oncology, University Hospital Heidelberg, Germany; Heidelberg Institute of Radiation Oncology, Germany
| | - A R Filippi
- Department of Oncology, University of Torino, Torino, Italy
| | - M M Fode
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - J Streblow
- Department of Radiation Oncology, University Hospital Heidelberg, Germany; Heidelberg Institute of Radiation Oncology, Germany
| | - S Adebahr
- Department of Radiation Oncology, University Hospital Freiburg, Germany
| | - N Andratschke
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland; Department of Radiation Oncology, University of Rostock, Germany
| | - O Blanck
- Department of Radiation Oncology, UKSH Universitätsklinikum Schleswig Holstein, Kiel, Germany
| | - J Boda-Heggemann
- Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Germany
| | - M Duma
- Department of Radiation Oncology, Technical University Munich, Germany
| | - M J Eble
- Department of Radiation Oncology, University Hospital Aachen, Germany
| | - I Ernst
- Department of Radiation Oncology, University Hospital Münster, Germany
| | - M Flentje
- Department of Radiation Oncology, University Hospital Wuerzburg, Germany
| | - S Gerum
- Department of Radiation Oncology, 11 Ludwig Maximilians University Munich, Germany
| | - P Hass
- Department of Radiation Oncology, University Hospital Magdeburg, Germany
| | - C Henkenberens
- Department of Radiotherapy and Special Oncology, Medical School Hannover, Germany
| | - G Hildebrandt
- Department of Radiation Oncology, University of Rostock, Germany
| | - D Imhoff
- Department of Radiation Oncology, University Hospital Frankfurt, Germany
| | - H Kahl
- Department of Radiation Oncology, Hospital Augsburg, Germany
| | - N D Klass
- Department of Radiation Oncology, Bern University Hospital, Bern, Switzerland
| | - R Krempien
- Department of Radiation Oncology, Helios Klinikum Berlin Buch, Germany
| | - F Lohaus
- Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; German Cancer Research Center (DKFZ), Heidelberg Germany and German Cancer Consortium (DKTK), Dresden, Germany; OncoRay - National Center for Radiation Research in Oncology (NCRO), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - C Petersen
- Department of Radiation Oncology, University Hospital Hamburg, Germany
| | - E Schrade
- Department of Radiation Oncology, Hospital Heidenheim, Germany
| | - T G Wendt
- Department of Radiation Oncology, University Hospital Jena, Germany
| | - A Wittig
- Department of Radiotherapy and Radiation Oncology, Philipps-University Marburg, University Hospital Giessen and Marburg, Germany
| | - M Høyer
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - U Ricardi
- Department of Oncology, University of Torino, Torino, Italy
| | - F Sterzing
- Department of Radiation Oncology, University Hospital Heidelberg, Germany; Heidelberg Institute of Radiation Oncology, Germany; German Cancer Research Center, Clinical Cooperation Unit Radiation Oncology, Heidelberg, Germany
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.
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Tufman A, Borgmeier A, Belka C, Ulm K, Tian F, Flentje M, Schnabel P, Goldmann T, Huber RM. Individualisation of radiochemotherapy (RTCT) for locally advanced non-small cell lung cancer (NSCLC). Pneumologie 2014. [DOI: 10.1055/s-0034-1376830] [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: 10/25/2022]
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Tufman A, Schuster T, Borgmeier A, Schmidt M, Ulm K, Flentje M, Huber RM. Ort der ersten Progression nach Radiochemotherapie (RTCT) des NSCLC im Stadium III: Unterschied zwischen simultaner Radiochemotherapie im Vergleich mit alleiniger Radiotherapie (RT) nach Induktionschemotherapie. Pneumologie 2014. [DOI: 10.1055/s-0034-1375927] [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: 10/25/2022]
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Holubyev K, Gainey M, Bratengeier K, Polat B, Flentje M. Generation of prostate IMAT plans adaptable to the inter-fractional changes of patient geometry. Phys Med Biol 2014; 59:1947-62. [PMID: 24694541 DOI: 10.1088/0031-9155/59/8/1947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We present the results of 2-Step generation of adaptable IMAT plans for prostate carcinoma cases. The 2-Step IMAT plans show clinical and dosimetric equivalence to the reference SmartArc™-generated VMAT plans. The 2-Step plans are adapted to inter-fractional changes of prostate-rectum geometry using 2-Step adaptation rules for a cohort of ten adaptation cases. The adapted 2-Step IMAT plans show statistically significant improvement (Wilcoxon 1-tail p < 0.05) of target coverage and of rectum sparing when compared to isocenter relocated plans.
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Affiliation(s)
- K Holubyev
- Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Würzburg, Joseph-Schneider Str. 11, D-97080 Würzburg, Germany
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Verburg FA, Sweeney R, Hänscheid H, Dießl S, Israel I, Löhr M, Vince GH, Flentje M, Reiners C, Samnick S. Patients with recurrent glioblastoma multiforme. Initial experience with p-[(131)I]iodo-L-phenylalanine and external beam radiation therapy. Nuklearmedizin 2013; 52:36-42. [PMID: 23303224 DOI: 10.3413/nukmed-0510-12-06] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 12/15/2012] [Indexed: 11/20/2022]
Abstract
AIM The objective of this study was to assess the feasibility, dosimetry, tolerability and efficacy of systemically administrated p-[(131)I]iodo-L-phenylalanine ((131)IPA) combined with hypo-fractionated external beam radiation therapy (EBRT) in patients with recurrent glioblastoma multiforme (GBM). PATIENTS, METHODS Five patients (2 women, 3 men, aged 27-69) with recurrent GBM and exhaustion of regular therapy options were included. All had a positive O-(2-[(18)F]Fluoroethyl)-L-tyrosine positron emission tomography (FET-PET) and pretherapeutic dosimetry was performed. Tumour targeting was verified by (131)IPA-SPECT up to six days after radiotracer administration. After (131)IPA therapy, patients were treated with hypo-fractionated EBRT in six fractions of 5 Gy (n = 4) or in eleven fractions of 2 Gy in one case. RESULTS Based on the individual dosimetry, the patients received a single intravenous administration of 2 to 7 GBq of (131)IPA, resulting in radiation absorbed doses to the blood of 0.80-1.47 Gy. The treatment was well tolerated; only minor complaints of nausea and vomiting that responded to ondansetron and pantoprazol were noticed in the first two patients. After preventive medication, the last three patients had no complaints during therapy. In none of the patients a decrease of leukocyte or thrombocyte counts below the baseline level or the lower normal limit was observed. Tumour doses from (131)IPA were low (≤ 1 Gy) and all patients died three to eight (median 5.5) months after therapy. CONCLUSION In this initial experience, treatment of GBM with (131)IPA in combination with EBRT was demonstrated to be safe and well tolerated, but less effective than suggested by the animal studies.
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Affiliation(s)
- F A Verburg
- Department of Nuclear Medicine, University of Würzburg, Germany.
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Guckenberger M, Saur G, Wehner D, Sweeney RA, Thalheimer A, Germer CT, Flentje M. Comparison of preoperative short-course radiotherapy and long-course radiochemotherapy for locally advanced rectal cancer. Strahlenther Onkol 2012; 188:551-7. [PMID: 22638934 DOI: 10.1007/s00066-012-0131-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Accepted: 03/28/2012] [Indexed: 12/18/2022]
Abstract
BACKGROUND The purpose of this work was to perform a single institution comparison between preoperative short-course radiotherapy (SC-RT) and long-course radiochemotherapy (LC-RCHT) for locally advanced rectal cancer. METHODS A total of 225 patients with clinical stage UICC II-III rectal cancer were treated with SC-RT (29 Gy in 10 twice daily fractions followed by immediate surgery; n = 108) or LC-RCHT (54 Gy in 28 fractions with simultaneous 5-fluorouracil (5-FU) ± oxaliplatin chemotherapy followed by delayed surgery; n = 117). All patients in the LC-RCHT cohort and patients in the SC-RT with pathological UICC stage ≥ II received adjuvant chemotherapy. Before 2004, the standard of care was SC-RT with LC-RCHT reserved for patients where downstaging was considered as required for sphincter preservation or curative resection. In the later period, SC-RT was practiced only for patients unfit for radiochemotherapy. RESULTS Patients in the LC-RCHT cohort had a significantly higher proportion of cT4 tumors, clinical node positivity, and lower tumor location. The 5-year local control (LC) and overall survival (OS) were 91% and 66% without differences between the SC-RT and LC-RCHT groups. Acute toxicity was increased during LC-RCHT (grade ≥ II 1% vs. 33%) and there were no differences in postoperative complications. Severe late toxicity grade ≥ III was increased after SC-RT (12% vs. 3%). Of patients aged > 80 years, 7 of 7 patients and 4 of 9 patients received curative surgery after SC-RT and LC-RCHT, respectively. CONCLUSION Despite the fact that patients with worse prognostic factors were treated with LC-RCHT, there were no significant differences in LC and OS between the SC-RT and LC-RCHT group. Age > 80 years was identified as a significant risk factor for LC-RCHT and these patients could be treated preferably with SC-RT.
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Affiliation(s)
- M Guckenberger
- Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
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Guckenberger M, Roesch J, Baier K, Sweeney R, Flentje M. OC-0045 GEOMETRIC AND DOSIMETRIC ACCURACY OF FRAME-LESS IMAGE-GUIDED RADIOSURGERY IN CLINICAL PRACTICE. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70384-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stingl L, Niewidok N, Müller N, Selle M, Djuzenova CS, Flentje M. Radiosensitizing effect of the novel Hsp90 inhibitor NVP-AUY922 in human tumour cell lines silenced for Hsp90α. Strahlenther Onkol 2012; 188:507-15. [PMID: 22441439 DOI: 10.1007/s00066-012-0080-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 01/11/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hsp90 inhibitors can enhance the tumour sensitivity to ionising radiation (IR). However, Hsp90 inhibition leads to the up-regulation of anti-apoptotic Hsp90 and Hsp70, which might diminish the radiosensitizing effects of the inhibitors. Therefore, inhibition of the up-regulation of Hsp90 by siRNA might be a promising strategy to enhance drug-mediated radiosensitization. MATERIALS AND METHODS The expression of Hsp90α was silenced in A549 and GaMG tumour cell lines by siRNA treatment. Pre-silenced for Hsp90α cells were treated with NVP-AUY922, a novel Hsp90 inhibitor, for 24 h and then irradiated. Radiation response was determined by colony-forming ability. The expression of several marker proteins was analysed by Western blot. DNA damage and repair were assessed by histone γH2AX measurements. RESULTS We found that transfection with siRNA against Hsp90α reduced Hsp90α at mRNA and protein levels. Pre-silencing of Hsp90α reduced NVP-AUY922-mediated up-regulation of Hsp90α but it did not increase drug-mediated radiosensitization in both tumour cell lines. As revealed by Western blot, pre-silencing of Hsp90α followed by NVP-AUY922 did not change the expression of Hsp90 client proteins (Akt, Raf-1, Cdk1 and Cdk4) compared with drug treatment alone, suggesting unchanged chaperone function in transfected cells. CONCLUSION Pre-silencing of Hsp90α followed by Hsp90 inhibition did not enhance the radiosensitizing effect of NVP-AUY922 in both tested tumour cell lines. Future work will be done on stable transfection with shRNA against Hsp90α or simultaneous silencing of both Hsp90 isoforms, Hsp90α and Hsp90β, in order to optimize tumour cell killing.
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Affiliation(s)
- L Stingl
- Department of Radiation Oncology, University of Würzburg, Würzburg, Germany
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Polat B, Kreissl M, Haenscheid H, Sweeney R, Reiners C, Buck A, Flentje M. External Beam Radiotherapy in Combination with Peptide Receptor Radionuclide Therapy (PRRT) in Irresectable or Recurrent Meningioma. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Goeckenjan G, Sitter H, Thomas M, Branscheid D, Flentje M, Griesinger F, Niederle N, Stuschke M, Blum T, Deppermann KM, Ficker J, Freitag L, Lübbe A, Reinhold T, Späth-Schwalbe E, Ukena D, Wickert M, Wolf M, Andreas S, Auberger T, Baum R, Baysal B, Beuth J, Bickeböller H, Böcking A, Bohle R, Brüske I, Burghuber O, Dickgreber N, Diederich S, Dienemann H, Eberhardt W, Eggeling S, Fink T, Fischer B, Franke M, Friedel G, Gauler T, Gütz S, Hautmann H, Hellmann A, Hellwig D, Herth F, Heußel C, Hilbe W, Hoffmeyer F, Horneber M, Huber R, Hübner J, Kauczor HU, Kirchbacher K, Kirsten D, Kraus T, Lang S, Martens U, Mohn-Staudner A, Müller KM, Müller-Nordhorn J, Nowak D, Ochmann U, Passlick B, Petersen I, Pirker R, Pokrajac B, Reck M, Riha S, Rübe C, Schmittel A, Schönfeld N, Schütte W, Serke M, Stamatis G, Steingräber M, Steins M, Stoelben E, Swoboda L, Teschler H, Tessen H, Weber M, Werner A, Wichmann HE, Irlinger Wimmer E, Witt C, Worth H. Prävention, Diagnostik, Therapie und Nachsorge des Lungenkarzinoms. Pneumologie 2011; 65:e51-75. [DOI: 10.1055/s-0030-1256562] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Gainey M, Bratengeier K, Flentje M. 416 poster COMPUTERISATION OF 2 STEP IMAT/IMRT SEGMENT GENERATION. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70538-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Guckenberger M, Richter A, Wilbert J, Flentje M, Partridge M. 95 oral ADAPTATION OF RADIOTHERAPY TO A SHRINKING MACROSCOPIC TUMOR IN ADVANCED STAGE NSCLC DOES NOT UNDERDOSE THE MICROSCOPIC DISEASE AND HAS THE POTENTIAL TO INCREASE TUMOR CONTROL PROBABILITY. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70218-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Moehler M, Al-Batran SE, Andus T, Anthuber M, Arends J, Arnold D, Aust D, Baier P, Baretton G, Bernhardt J, Boeing H, Böhle E, Bokemeyer C, Bornschein J, Budach W, Burmester E, Caca K, Diemer WA, Dietrich CF, Ebert M, Eickhoff A, Ell C, Fahlke J, Feussner H, Fietkau R, Fischbach W, Fleig W, Flentje M, Gabbert HE, Galle PR, Geissler M, Gockel I, Graeven U, Grenacher L, Gross S, Hartmann JT, Heike M, Heinemann V, Herbst B, Herrmann T, Höcht S, Hofheinz RD, Höfler H, Höhler T, Hölscher AH, Horneber M, Hübner J, Izbicki JR, Jakobs R, Jenssen C, Kanzler S, Keller M, Kiesslich R, Klautke G, Körber J, Krause BJ, Kuhn C, Kullmann F, Lang H, Link H, Lordick F, Ludwig K, Lutz M, Mahlberg R, Malfertheiner P, Merkel S, Messmann H, Meyer HJ, Mönig S, Piso P, Pistorius S, Porschen R, Rabenstein T, Reichardt P, Ridwelski K, Röcken C, Roetzer I, Rohr P, Schepp W, Schlag PM, Schmid RM, Schmidberger H, Schmiegel WH, Schmoll HJ, Schuch G, Schuhmacher C, Schütte K, Schwenk W, Selgrad M, Sendler A, Seraphin J, Seufferlein T, Stahl M, Stein H, Stoll C, Stuschke M, Tannapfel A, Tholen R, Thuss-Patience P, Treml K, Vanhoefer U, Vieth M, Vogelsang H, Wagner D, Wedding U, Weimann A, Wilke H, Wittekind C. [German S3-guideline "Diagnosis and treatment of esophagogastric cancer"]. Z Gastroenterol 2011; 49:461-531. [PMID: 21476183 DOI: 10.1055/s-0031-1273201] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- M Moehler
- Medizinische Klinik und Poliklinik, Johannes-Gutenberg-Universität, Langenbeckstraße 1, 55101 Mainz.
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Goeckenjan G, Sitter H, Thomas M, Branscheid D, Flentje M, Griesinger F, Niederle N, Stuschke M, Blum T, Deppermann KM, Ficker J, Freitag L, Lübbe A, Reinhold T, Späth-Schwalbe E, Ukena D, Wickert M, Wolf M, Andreas S, Auberger T, Baum R, Baysal B, Beuth J, Bickeböller H, Böcking A, Bohle R, Brüske I, Burghuber O, Dickgreber N, Diederich S, Dienemann H, Eberhardt W, Eggeling S, Fink T, Fischer B, Franke M, Friedel G, Gauler T, Gütz S, Hautmann H, Hellmann A, Hellwig D, Herth F, Heußel C, Hilbe W, Hoffmeyer F, Horneber M, Huber R, Hübner J, Kauczor HU, Kirchbacher K, Kirsten D, Kraus T, Lang S, Martens U, Mohn-Staudner A, Müller KM, Müller-Nordhorn J, Nowak D, Ochmann U, Passlick B, Petersen I, Pirker R, Pokrajac B, Reck M, Riha S, Rübe C, Schmittel A, Schönfeld N, Schütte W, Serke M, Stamatis G, Steingräber M, Steins M, Stoelben E, Swoboda L, Teschler H, Tessen H, Weber M, Werner A, Wichmann HE, Irlinger Wimmer E, Witt C, Worth H. Prevention, Diagnosis, Therapy, and Follow-up of Lung Cancer. Pneumologie 2010; 65:39-59. [DOI: 10.1055/s-0030-1255961] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Polat B, Said H, Katzer A, Guckenberger M, Mlynski R, Flentje M, Vordermark D. Osteopontin Plasma Levels in Head and Neck Cancer Patients During Radiotherapy. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Dietz A, Flentje M, Hagen R, Kortmann RD, Hildebrand G, Hoppe F, Schwienhorst I, Keilholz U. Docetaxel, cisplatin (TP), and radiation with or without cetuximab in advanced larynx carcinoma (DeLOS II trial). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps265] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kuhnt T, Sandner A, Wendt T, Engenhart-Cabillic R, Lammering G, Flentje M, Grabenbauer G, Schreiber A, Pirnasch A, Dunst J. Phase I trial of dose-escalated cisplatin with concomitant cetuximab and hyperfractionated-accelerated radiotherapy in locally advanced squamous cell carcinoma of the head and neck. Ann Oncol 2010; 21:2284-2289. [PMID: 20427347 DOI: 10.1093/annonc/mdq216] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cetuximab is active in the treatment of squamous cell carcinoma of the head and neck (SCCHN), enhancing both radiotherapy and chemotherapy effects. This phase I study was designed to investigate the safety and tolerability of combining weekly cisplatin treatment with cetuximab and hyperfractionated-accelerated radiotherapy (HART) for locally advanced SCCHN. PATIENTS AND METHODS Patients with unresectable stage III or IVA/B SCCHN were treated with cetuximab, 400 mg/m² initial dose on day -7 of HART, followed by 250 mg/m² weekly during the administration of HART, which started with 2.0 Gy/day (5 days/week) for 3 weeks followed by 1.4 Gy/twice-daily (Monday to Friday) for another 3 weeks, resulting in a total dose of 70.6 Gy. Cisplatin was administered weekly starting on the first day of radiotherapy until week 6. Cisplatin was dose escalated of four dose levels from 20 to 40 mg/m² using a classical 3 + 3 dose escalation algorithm. RESULTS Eighteen patients were enrolled. Sixteen patients were eligible for toxicity, and 15 for response. No maximum tolerated dose was reached for cisplatin. One of six patients of dose level 4 had grade 4 neutropenia. This patient died 1 week after the end of the study treatment. The most common types of grade 3+ adverse events were mucositis (9 of 16 patients), in-field dermatitis (6 of 16 patients) and neutropenia (4 of 16 patients). Cetuximab-related hypersensitivity was observed in 1 out of 18 patients. Six weeks after the end of the study treatment, 5 complete responses, 8 partial responses and 1 progressive disease (at distant sites) were documented in a total of 15 patients (objective response rate 87%). CONCLUSIONS The combination of cisplatin with cetuximab and HART is active, well tolerated and merits additional investigation. The recommended weekly dose of cisplatin for phase II studies is 40 mg/m².
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Affiliation(s)
- T Kuhnt
- Department of Radiation Oncology, University of Rostock, Rostock.
| | - A Sandner
- Department of Head and Neck Surgery, Martin-Luther-University, Halle-Wittenberg
| | - T Wendt
- Department of Radiation Oncology, Friedrich-Schiller-University, Jena
| | | | - G Lammering
- Department of Radiation Oncology (Maastro Clinic), Maastricht, The Netherlands; Department of Radiation Therapy and Radiation Oncology, University of Düsseldorf, Düsseldorf
| | - M Flentje
- Department of Radiation Oncology, University of Würzburg, Würzburg
| | - G Grabenbauer
- Department of Radiation Oncology, Hospital Coburg, Coburg
| | - A Schreiber
- Department of Radiation Oncology, Hospital Dresden-Friedrichstadt, Friedrichstadt
| | - A Pirnasch
- Department of Radiation Oncology, University of Rostock, Rostock
| | - J Dunst
- Department of Radiation Oncology, University of Schleswig-Holstein, Campus Lübeck, Germany
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Goeckenjan G, Sitter H, Thomas M, Branscheid D, Flentje M, Griesinger F, Niederle N, Stuschke M, Blum T, Deppermann KM, Ficker JH, Freitag L, Lübbe AS, Reinhold T, Späth-Schwalbe E, Ukena D, Wickert M, Wolf M, Andreas S, Auberger T, Baum RP, Baysal B, Beuth J, Bickeböller H, Böcking A, Bohle RM, Brüske I, Burghuber O, Dickgreber N, Diederich S, Dienemann H, Eberhardt W, Eggeling S, Fink T, Fischer B, Franke M, Friedel G, Gauler T, Gütz S, Hautmann H, Hellmann A, Hellwig D, Herth F, Heussel CP, Hilbe W, Hoffmeyer F, Horneber M, Huber RM, Hübner J, Kauczor HU, Kirchbacher K, Kirsten D, Kraus T, Lang SM, Martens U, Mohn-Staudner A, Müller KM, Müller-Nordhorn J, Nowak D, Ochmann U, Passlick B, Petersen I, Pirker R, Pokrajac B, Reck M, Riha S, Rübe C, Schmittel A, Schönfeld N, Schütte W, Serke M, Stamatis G, Steingräber M, Steins M, Stoelben E, Swoboda L, Teschler H, Tessen HW, Weber M, Werner A, Wichmann HE, Irlinger Wimmer E, Witt C, Worth H. [Prevention, diagnosis, therapy, and follow-up of lung cancer]. Pneumologie 2010; 64 Suppl 2:e1-164. [PMID: 20217630 DOI: 10.1055/s-0029-1243837] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Guckenberger M, Richter A, Wilbert J, Krieger T, Baier K, Flentje M. How Much Lung Sparing is Achievable by Adaptive Radiotherapy in Treatment of Advanced-stage Non–small-cell Lung Cancer? Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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42
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Guckenberger M, Richter A, Krieger T, Wilbert J, Baier K, Flentje M. IS ONE SINGLE ARC SUFFICIENT IN VOLUMETRIC MODULATED ARC THERAPY FOR COMPLEX SHAPED TARGET VOLUMES? Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)73098-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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43
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Gainey M, Bratengeier K, Polat B, Meyer J, Flentje M. MO-D-BRB-09: IMRT Ad-Hoc Adaption - Initial Results for Prostate: A Retrospective Planning Study. Med Phys 2009. [DOI: 10.1118/1.3182219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Wilkowski R, Boeck S, Ostermaier S, Sauer R, Herbst M, Fietkau R, Flentje M, Bruns CJ, Rau HG, Heinemann V. Final analysis of a multicenter, randomized phase II trial comparing three different chemoradiotherapy regimens in the treatment of patients with locally advanced, nonmetastatic pancreatic cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4610 Background: To date, no standard treatment approach for patients (pts) with non-resectable, locally advanced pancreatic cancer (PC) is defined. Methods: Within a prospective phase II trial treatment-naive pts with locally advanced PC and adequate organ function were randomly assigned to three different CRT regimens; all pts received a conventionally fractionated radiotherapy of 50 Gy (with a daily dose of 2.0 Gy) and were randomized to either concurrent 5-FU as a 24h-infusion (350 mg/m2/d on each day of radiotherapy, RT-5FU arm), concurrent low-dose gemcitabine 300 mg/m2 and cisplatin 30 mg/m2 on days 1, 8, 22, and 29 (RT-GC arm), or the same concurrent treatment followed by a sequential chemotherapy with full- dose gemcitabine (1000 mg/m2) and cisplatin (50 mg/m2) every two weeks (RT-GC+GC arm). Treatment duration in the RT- GC+GC arm was upon disease progression or unacceptable toxicity. The primary study endpoint was the overall survival (OS) rate after 9 months (mo); secondary endpoints included response rate (WHO criteria), progression-free survival (PFS), resectability and toxicity. Results: Ninety-five patients (median age 64 years, 54% male, 50% KPS 90–100%) were recruited from 12 German centers. Seventy patients were evaluable for objective response: the intent-to-treat response rate (CR+PR) was 19% in the RT-5FU arm, 22% in the RT-GC arm and 13% in the RT-GC+GC arm, respectively. Overall, 18 pts (19%) underwent surgical resection after initial CRT (R0 in 8 pts). After a median follow-up of 8.6 mo, median PFS was estimated with 4 mo (RT-5FU), 5.6 mo (RT-GC) and 6 mo (RT- GC+GC), respectively (p=0.21). The corresponding median OS times were 9.6 mo, 9.3 mo and 7.3 mo (p=0.61). Hematological grade 3/4 toxicities were higher in the two gemcitabine/cisplatin-containing arms, but no grade 3/4 febrile neutopenia was observed. Regarding non-hematological toxicity, nausea/vomiting were more frequently in the RT-GC and RT-GC+GC arm, whereas diarrhea was more frequent in the RT-5FU arm. Conclusions: Based on these data, gemcitabine/cisplatin-based CRT does not achieve a higher clinical efficacy compared to RT-5FU, and is associated with increased hematological toxicity. [Table: see text]
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Affiliation(s)
- R. Wilkowski
- Klinik Bad Trissl, Oberaudorf, Germany; Klinikum Grosshadern, University of Munich, Munich, Germany; University of Erlangen, Erlangen, Germany; University of Regensburg, Regensburg, Germany; University of Rostock, Rostock, Germany; University of Würzburg, Würzburg, Germany; Klinikum Dachau, Dachau, Germany
| | - S. Boeck
- Klinik Bad Trissl, Oberaudorf, Germany; Klinikum Grosshadern, University of Munich, Munich, Germany; University of Erlangen, Erlangen, Germany; University of Regensburg, Regensburg, Germany; University of Rostock, Rostock, Germany; University of Würzburg, Würzburg, Germany; Klinikum Dachau, Dachau, Germany
| | - S. Ostermaier
- Klinik Bad Trissl, Oberaudorf, Germany; Klinikum Grosshadern, University of Munich, Munich, Germany; University of Erlangen, Erlangen, Germany; University of Regensburg, Regensburg, Germany; University of Rostock, Rostock, Germany; University of Würzburg, Würzburg, Germany; Klinikum Dachau, Dachau, Germany
| | - R. Sauer
- Klinik Bad Trissl, Oberaudorf, Germany; Klinikum Grosshadern, University of Munich, Munich, Germany; University of Erlangen, Erlangen, Germany; University of Regensburg, Regensburg, Germany; University of Rostock, Rostock, Germany; University of Würzburg, Würzburg, Germany; Klinikum Dachau, Dachau, Germany
| | - M. Herbst
- Klinik Bad Trissl, Oberaudorf, Germany; Klinikum Grosshadern, University of Munich, Munich, Germany; University of Erlangen, Erlangen, Germany; University of Regensburg, Regensburg, Germany; University of Rostock, Rostock, Germany; University of Würzburg, Würzburg, Germany; Klinikum Dachau, Dachau, Germany
| | - R. Fietkau
- Klinik Bad Trissl, Oberaudorf, Germany; Klinikum Grosshadern, University of Munich, Munich, Germany; University of Erlangen, Erlangen, Germany; University of Regensburg, Regensburg, Germany; University of Rostock, Rostock, Germany; University of Würzburg, Würzburg, Germany; Klinikum Dachau, Dachau, Germany
| | - M. Flentje
- Klinik Bad Trissl, Oberaudorf, Germany; Klinikum Grosshadern, University of Munich, Munich, Germany; University of Erlangen, Erlangen, Germany; University of Regensburg, Regensburg, Germany; University of Rostock, Rostock, Germany; University of Würzburg, Würzburg, Germany; Klinikum Dachau, Dachau, Germany
| | - C. J. Bruns
- Klinik Bad Trissl, Oberaudorf, Germany; Klinikum Grosshadern, University of Munich, Munich, Germany; University of Erlangen, Erlangen, Germany; University of Regensburg, Regensburg, Germany; University of Rostock, Rostock, Germany; University of Würzburg, Würzburg, Germany; Klinikum Dachau, Dachau, Germany
| | - H. G. Rau
- Klinik Bad Trissl, Oberaudorf, Germany; Klinikum Grosshadern, University of Munich, Munich, Germany; University of Erlangen, Erlangen, Germany; University of Regensburg, Regensburg, Germany; University of Rostock, Rostock, Germany; University of Würzburg, Würzburg, Germany; Klinikum Dachau, Dachau, Germany
| | - V. Heinemann
- Klinik Bad Trissl, Oberaudorf, Germany; Klinikum Grosshadern, University of Munich, Munich, Germany; University of Erlangen, Erlangen, Germany; University of Regensburg, Regensburg, Germany; University of Rostock, Rostock, Germany; University of Würzburg, Würzburg, Germany; Klinikum Dachau, Dachau, Germany
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Kuhnt T, Sandner A, Wendt TG, Engenhardt-Cabillic R, Lammering G, Flentje M, Grabenbauer GG, Pirnasch A, Baumann M, Dunst J. Concomitant hyperfractionated accelerated radiotherapy (HART) with cisplatin and concurrent cetuximab for locoregionally advanced squamous cell head and neck cancer: a phase I dose escalation trial. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.6029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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46
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Dietz A, Keilholz U, Werner J, Hagen R, Flentje M, Iro H. Stellenwert der Induktionstherapie bei Kopf-Hals-Tumoren. Laryngorhinootologie 2008; 87:237-43; discussion 244. [DOI: 10.1055/s-2007-995588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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47
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Guckenberger M, Krieger T, Wilbert J, Baier K, Richter A, Polat B, Flentje M. Four Dimensional Target Volume Generation in Pulmonary Stereotactic Body Radiotherapy. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.345] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kortmann RD, Bongartz R, Dieckmann K, Dunst J, Flentje M, Gademann G, Christiansen H, Kamprad FH, Karstens JH, Pape H, Rühl U, Schmidt BF, Willich N, Schulz-Ertner D, Schwarz R, Timmermann B, Pohl F, Klingebiel T, Jürgens H, Rübe C. [Requirements and performance profile of the Paediatric Radiation Oncology Working Group (APRO): evaluation of the present situation and description of future developments]. Klin Padiatr 2007; 219:166-72. [PMID: 17525911 DOI: 10.1055/s-2007-973855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Radiation therapy is an integral component in the management of childhood malignancies and undergoes a continuous process of optimization within the prospective trials of the GPOH. At present there are approximately 20 active protocols, some specifying radio-oncological study questions, in which about 500 to 600 children annually are given radiotherapy. MATERIALS/METHODS The Pediatric Radiation Oncology Working Group (APRO) of the German Society for Radiation Oncology (DEGRO) represents the organizational link between GPOH and DEGRO. Their activities range from phrasing guidelines of radio-oncological therapy, through writing a protocol for a prospective study on radiation-induced late effects (RISK--in co-operation with GPOH, 695 patients registered so far) and organizing meetings for information transfer, to implementing radio-oncology within the prospective studies of the GPOH by establishing study chairs for radio-oncology when radio-oncological questions are a primary focus and/or to function as a reference institution for quality assurance. These activities also include individual case consultations outside the study proper. Twice annually the members of the APRO meet for an update on current knowledge and future directions where a representative of the GPOH is invited to contribute special aspects of pediatric oncology. CONCLUSIONS In the future, modern technology (intensity modulated radiotherapy, proton therapy, inclusion of imaging in treatment planning) will be part of disease management in pediatric oncology. A working group for modern radiotherapy technology was established to enhance this development. Prospective studies of the GPOH with primary or secondary radio-oncological questions require the implementation of corresponding tasks (documentation, monitoring, etc.) in order to meet future demands on clinical trials and to achieve the aims of the protocol. Consequently adequate financial support is indispensable.
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Affiliation(s)
- R-D Kortmann
- Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universität Leipzig, Stephanstrasse 9A, 04103 Leipzig.
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Pfreundner L, Relic A, Guckenberger M, Voelter C, Schwab F, Hoppe F, Hagen R, Flentje M. Organ preservation by induction chemotherapy and CT-based 3D radiotherapy in patients with advanced laryn geal and hypopharyngeal carcinomas. Radiother Oncol 2007. [DOI: 10.1016/s0167-8140(07)80185-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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50
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Flentje M, Heilmann K, Wulf J, Mueller G, Beckmann G, Guckenberger M. 2455. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.866] [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: 11/16/2022]
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