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Mortensen HR, Populaire P, Hoffmann L, Moeller DS, Appelt A, Nafteux P, Muijs CT, Grau C, Hawkins MA, Troost EGC, Defraene G, Canters R, Clarke CS, Weber DC, Korevaar EW, Haustermans K, Nordsmark M, Gebski V, Achiam MP, Markar SR, Radhakrishna G, Berbee M, Scartoni D, Orlandi E, Doyen J, Gregoire V, Crehange G, Langendijk J, Lorgelly P, Blommenstein HM, Byskov CS, Ehmsen ML, Jensen MF, Freixas GV, Bütof R. Proton versus photon therapy for esophageal cancer - A trimodality strategy (PROTECT) NCT050555648: A multicenter international randomized phase III study of neoadjuvant proton versus photon chemoradiotherapy in locally advanced esophageal cancer. Radiother Oncol 2024; 190:109980. [PMID: 37935284 DOI: 10.1016/j.radonc.2023.109980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/29/2023] [Accepted: 10/29/2023] [Indexed: 11/09/2023]
Affiliation(s)
- H R Mortensen
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark
| | - P Populaire
- University Hospitals Leuven, Department of Radiation Oncology, Belgium; KU Leuven- University of Leuven, Department of Oncology, Laboratory of Experimental Radiotherapy, Leuven, Belgium
| | - L Hoffmann
- Department of Oncology and Medical Physics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark
| | - D S Moeller
- Department of Oncology and Medical Physics, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark
| | | | - P Nafteux
- University Hospitals Leuven, Department of Thoracic Surgery, Belgium
| | - C T Muijs
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - C Grau
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - M A Hawkins
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - E G C Troost
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, and Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology - OncoRay Helmholtz-Zentrum Dresden-Rossendorf, Germany
| | - G Defraene
- KU Leuven- University of Leuven, Department of Oncology, Laboratory of Experimental Radiotherapy, Leuven, Belgium
| | - R Canters
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical Centre+, the Netherlands
| | - C S Clarke
- Research Dept. of Primary Care and Population Health, University College London, London, UK
| | - D C Weber
- Center for Proton Therapy, Paul Scherrer Institut, Villigen, Switzerland; Radiation Oncology Department, University Hospital Zurich, Zurich, Switzerland
| | - E W Korevaar
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - K Haustermans
- University Hospitals Leuven, Department of Radiation Oncology, Belgium; KU Leuven- University of Leuven, Department of Oncology, Laboratory of Experimental Radiotherapy, Leuven, Belgium
| | - M Nordsmark
- Department of Oncology and Medical Physics, Aarhus University Hospital, Aarhus, Denmark
| | - Val Gebski
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
| | - M P Achiam
- Dept. Surgery and Transplantation, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Sheraz R Markar
- Department of General Surgery, Oxford University Hospitals, Oxford, UK; Nuffield Department of Surgery, University of Oxford, Oxford, UK
| | | | - Maaike Berbee
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Daniele Scartoni
- Proton Therapy Center, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Ester Orlandi
- National Center for Oncological Hadrontherapy (CNAO), Radiation Oncology Clinical Department, Pavia, Italy
| | | | | | - Gilles Crehange
- PSL Research University, RadiationOncology Department, Institut Curie, Paris/Orsay, France
| | - Johannes Langendijk
- Department of Radiation Oncology, UniversityMedicalCentreGroningen, Groningen, The Netherlands
| | - Paula Lorgelly
- University of Auckland, Waipara Taumata Rau, Auckland, New Zealand
| | - Hedwig M Blommenstein
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, Rotterdam, 3000 DR, The Netherlands; Erasmus Centre for Health Economics Rotterdam, Erasmus University, Rotterdam, The Netherlands
| | - Camilla S Byskov
- Department of Oncology and Medical physics, Aarhus University Hospital, Aarhus, Denmark
| | - Mai L Ehmsen
- Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | | | - Gloria Vilches Freixas
- Maastro Proton Therapy, Department of Radiation Oncology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Rebecca Bütof
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden and OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, and Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology - OncoRay Helmholtz-Zentrum Dresden-Rossendorf, Germany
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2
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Honke J, Hoffmann L, Coras R, Kobow K, Leu C, Pieper T, Hartlieb T, Bien CG, Woermann F, Cloppenborg T, Kalbhenn T, Gaballa A, Hamer H, Brandner S, Rössler K, Dörfler A, Rampp S, Lemke JR, Baldassari S, Baulac S, Lal D, Nürnberg P, Blümcke I. Deep histopathology genotype-phenotype analysis of focal cortical dysplasia type II differentiates between the GATOR1-altered autophagocytic subtype IIa and MTOR-altered migration deficient subtype IIb. Acta Neuropathol Commun 2023; 11:179. [PMID: 37946310 PMCID: PMC10633947 DOI: 10.1186/s40478-023-01675-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/21/2023] [Indexed: 11/12/2023] Open
Abstract
Focal cortical dysplasia type II (FCDII) is the most common cause of drug-resistant focal epilepsy in children. Herein, we performed a deep histopathology-based genotype-phenotype analysis to further elucidate the clinico-pathological and genetic presentation of FCDIIa compared to FCDIIb. Seventeen individuals with histopathologically confirmed diagnosis of FCD ILAE Type II and a pathogenic variant detected in brain derived DNA whole-exome sequencing or mTOR gene panel sequencing were included in this study. Clinical data were directly available from each contributing centre. Histopathological analyses were performed from formalin-fixed, paraffin-embedded tissue samples using haematoxylin-eosin and immunohistochemistry for NF-SMI32, NeuN, pS6, p62, and vimentin. Ten individuals carried loss-of-function variants in the GATOR1 complex encoding genes DEPDC5 (n = 7) and NPRL3 (n = 3), or gain-of-function variants in MTOR (n = 7). Whereas individuals with GATOR1 variants only presented with FCDIIa, i.e., lack of balloon cells, individuals with MTOR variants presented with both histopathology subtypes, FCDIIa and FCDIIb. Interestingly, 50% of GATOR1-positive cases showed a unique and predominantly vacuolizing phenotype with p62 immunofluorescent aggregates in autophagosomes. All cases with GATOR1 alterations had neurosurgery in the frontal lobe and the majority was confined to the cortical ribbon not affecting the white matter. This pattern was reflected by subtle or negative MRI findings in seven individuals with GATOR1 variants. Nonetheless, all individuals were seizure-free after surgery except four individuals carrying a DEPDC5 variant. We describe a yet underrecognized genotype-phenotype correlation of GATOR1 variants with FCDIIa in the frontal lobe. These lesions were histopathologically characterized by abnormally vacuolizing cells suggestive of an autophagy-altered phenotype. In contrast, individuals with FCDIIb and brain somatic MTOR variants showed larger lesions on MRI including the white matter, suggesting compromised neural cell migration.
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Affiliation(s)
- Jonas Honke
- Department of Neuropathology, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
- Partner of the European Reference Network (ERN) EpiCARE, Barcelona, Spain
| | - Lucas Hoffmann
- Department of Neuropathology, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
- Partner of the European Reference Network (ERN) EpiCARE, Barcelona, Spain
| | - Roland Coras
- Department of Neuropathology, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
- Partner of the European Reference Network (ERN) EpiCARE, Barcelona, Spain
| | - Katja Kobow
- Department of Neuropathology, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
- Partner of the European Reference Network (ERN) EpiCARE, Barcelona, Spain
| | - Costin Leu
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
- Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK
- Department of Neurology, McGovern Medical School, UTHealth Houston, University of Texas, Houston, USA
| | - Tom Pieper
- Center for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schoen-Clinic, Vogtareuth, Germany
| | - Till Hartlieb
- Center for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schoen-Clinic, Vogtareuth, Germany
- Research Institute for Rehabilitation, Transition, and Palliation, Paracelsus Medical University, Salzburg, Austria
| | - Christian G Bien
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany
| | - Friedrich Woermann
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany
| | - Thomas Cloppenborg
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany
| | - Thilo Kalbhenn
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany
- Department of Neurosurgery (Evangelisches Klinikum Bethel), Medical School, Bielefeld University, Bielefeld, Germany
| | - Ahmed Gaballa
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany
| | - Hajo Hamer
- Partner of the European Reference Network (ERN) EpiCARE, Barcelona, Spain
- Epilepsy Center, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Sebastian Brandner
- Department of Neurosurgery, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Karl Rössler
- Department of Neurosurgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Arnd Dörfler
- Department of Neuroradiology, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Stefan Rampp
- Department of Neurosurgery, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
- Department of Neuroradiology, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Johannes R Lemke
- Institute of Human Genetics, University of Leipzig Medical Center, Leipzig, Germany
- Center for Rare Diseases, University of Leipzig Medical Center, Leipzig, Germany
| | - Sara Baldassari
- Inserm, CNRS, APHP, Institut du Cerveau - Paris Brain Institute - ICM, Hôpital de La Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - Stéphanie Baulac
- Inserm, CNRS, APHP, Institut du Cerveau - Paris Brain Institute - ICM, Hôpital de La Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - Dennis Lal
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA, 02142, USA
- Cologne Center for Genomics (CCG), Medical Faculty of the University of Cologne, University Hospital of Cologne, 50931, Cologne, Germany
- Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK
- Department of Neurology, McGovern Medical School, UTHealth Houston, University of Texas, Houston, USA
| | - Peter Nürnberg
- Cologne Center for Genomics (CCG), Medical Faculty of the University of Cologne, University Hospital of Cologne, 50931, Cologne, Germany
| | - Ingmar Blümcke
- Department of Neuropathology, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany.
- Partner of the European Reference Network (ERN) EpiCARE, Barcelona, Spain.
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA, 02142, USA.
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Knap MM, Khan S, Khalil AA, Møller DS, Hoffmann L. Outcome of conventional radiotherapy in small centrally located tumours or lymph nodes: minimal toxicity, remarkable survival but challenging loco-regional control. Acta Oncol 2023; 62:1433-1439. [PMID: 37707506 DOI: 10.1080/0284186x.2023.2257872] [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] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/04/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND In peripheral lung tumours, stereotactic body radiotherapy (SBRT) is superior to conventional RT. SBRT has also shown high loco-regional control (LC) in centrally located tumours, but there is a high risk of severe toxicity. The STRICTSTARLung trial (NCT05354596) examines if risk-adapted SBRT for central tumours is feasible. In this study, we examined overall survival (OS), Disease-free survival (DSF), LC, and toxicity in patients with central tumours that could have been candidates for SBRT but received conventional RT. MATERIAL AND METHODS Retrospectively, we evaluated 49 lung cancer patients that between 2008 and 2021 received RT (60-70Gy in 2 Gy fractions) for a solitary tumour or lymph node with a diameter <5cm located <2cm from the bronchial tree, oesophagus, aorta or heart. All tumours were pathologically verified; 30 were primary lung tumours (T1b-T4) and 19 were solitary lymph nodes (T0N1-N2). Chemotherapy was administered as concomitant (29) or sequential (4). OS and LC were analysed using Kaplan Meier. Cox proportional hazards model for OS and disease-free survival (DFS) was performed including tumour volume, histology, sex, T- vs N-site and chemotherapy. Toxicity was scored. RESULTS In 42 patients, the tumour was located <1 cm to mediastinum. Median follow-up time was 44 months (range: 7-123). The median OS was 51 months. OS at 1-, 3- and 5-year was 88% (SE:5), 59% (SE:7) and 50% (SE:8). Loco-regional recurrences occurred in 16 patients resulting in 1-, and 3-year LC rates of 77% (SE:6) and 64% (SE:8). The majority occurred within 3 years after RT. Only stage showed significant impact on OS and DFS. No patients experienced grade 4-5 toxicity. Seven patients developed grade 3 toxicity (5 oesophageal stenosis, 2 pneumonitis). CONCLUSION Conventional RT for patients with small central lung tumours or solitary lymph nodes is feasible. Median OS was 51 months, and toxicity was low with no grade 4-5 events.
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Affiliation(s)
- M M Knap
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark
| | - S Khan
- Department of Respiratory Diseases and Allergology, Aarhus University Hospital, Aarhus N, Denmark
| | - A A Khalil
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - D S Møller
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - L Hoffmann
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
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Dierig A, Hoelscher M, Schultz S, Hoffmann L, Jarchow-MacDonald A, Svensson EM, Te Brake L, Aarnoutse R, Boeree M, McHugh TD, Wildner LM, Gong X, Phillips P, Minja LT, Ntinginya N, Mpagama S, Liyoyo A, Wallis RS, Sebe M, Mhimbira FA, Mbeya B, Rassool M, Geiter L, Cho YL, Heinrich N. A phase IIb, open-label, randomized controlled dose ranging multi-centre trial to evaluate the safety, tolerability, pharmacokinetics and exposure-response relationship of different doses of delpazolid in combination with bedaquiline delamanid moxifloxacin in adult subjects with newly diagnosed, uncomplicated, smear-positive, drug-sensitive pulmonary tuberculosis. Trials 2023; 24:382. [PMID: 37280643 DOI: 10.1186/s13063-023-07354-5] [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] [Received: 09/01/2022] [Accepted: 05/05/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Linezolid is an effective, but toxic anti-tuberculosis drug that is currently recommended for the treatment of drug-resistant tuberculosis. Improved oxazolidinones should have a better safety profile, while preserving efficacy. Delpazolid is a novel oxazolidinone developed by LegoChem Biosciences Inc. that has been evaluated up to phase 2a clinical trials. Since oxazolidinone toxicity can occur late in treatment, LegoChem Biosciences Inc. and the PanACEA Consortium designed DECODE to be an innovative dose-ranging study with long-term follow-up for determining the exposure-response and exposure-toxicity relationship of delpazolid to support dose selection for later studies. Delpazolid is administered in combination with bedaquiline, delamanid and moxifloxacin. METHODS Seventy-five participants with drug-sensitive, pulmonary tuberculosis will receive bedaquiline, delamanid and moxifloxacin, and will be randomized to delpazolid dosages of 0 mg, 400 mg, 800 mg, 1200 mg once daily, or 800 mg twice daily, for 16 weeks. The primary efficacy endpoint will be the rate of decline of bacterial load on treatment, measured by MGIT liquid culture time to detection from weekly sputum cultures. The primary safety endpoint will be the proportion of oxazolidinone class toxicities; neuropathy, myelosuppression, or tyramine pressor response. Participants who convert to negative liquid media culture by week 8 will stop treatment after the end of their 16-week course and will be observed for relapse until week 52. Participants who do not convert to negative culture will receive continuation phase treatment with rifampicin and isoniazid to complete a six-month treatment course. DISCUSSION DECODE is an innovative dose-finding trial, designed to support exposure-response modelling for safe and effective dose selection. The trial design allows assessment of occurrence of late toxicities as observed with linezolid, which is necessary in clinical evaluation of novel oxazolidinones. The primary efficacy endpoint is the change in bacterial load, an endpoint conventionally used in shorter dose-finding trials. Long-term follow-up after shortened treatment is possible through a safety rule excluding slow-and non-responders from potentially poorly performing dosages. TRIAL REGISTRATION DECODE was registered in ClinicalTrials.gov before recruitment start on 22 October 2021 (NCT04550832).
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Affiliation(s)
- A Dierig
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Munich, Germany
- German Center for Infection Research (DZIF), Munich partner site, Munich, Germany
| | - M Hoelscher
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Munich, Germany
- German Center for Infection Research (DZIF), Munich partner site, Munich, Germany
| | - S Schultz
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Munich, Germany
- German Center for Infection Research (DZIF), Munich partner site, Munich, Germany
| | - L Hoffmann
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Munich, Germany
- German Center for Infection Research (DZIF), Munich partner site, Munich, Germany
| | - A Jarchow-MacDonald
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Munich, Germany
- German Center for Infection Research (DZIF), Munich partner site, Munich, Germany
- Ninewells Hospital and Medical School, NHS Tayside, Dundee, UK
| | - E M Svensson
- Department of Pharmacy, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - L Te Brake
- Department of Pharmacy, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - R Aarnoutse
- Department of Pharmacy, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - M Boeree
- Department of Pharmacy, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - T D McHugh
- Division of Infection & Immunity, UCL Centre for Clinical Microbiology, University College of London, London, UK
| | - L M Wildner
- Division of Infection & Immunity, UCL Centre for Clinical Microbiology, University College of London, London, UK
| | - X Gong
- Department of Medicine, Division of Pulmonary & Critical Care Medicine, University of California San Francisco, San Francisco, USA
| | - Ppj Phillips
- Department of Medicine, Division of Pulmonary & Critical Care Medicine, University of California San Francisco, San Francisco, USA
| | - L T Minja
- National Institute for Medical Research, Mbeya Medical Research Centre (NIMR-MMRC), Mbeya, Tanzania
| | - N Ntinginya
- National Institute for Medical Research, Mbeya Medical Research Centre (NIMR-MMRC), Mbeya, Tanzania
| | - S Mpagama
- Kilimanjaro Clinical Research Institute, Kilimanjaro, Tanzania
| | - A Liyoyo
- Kilimanjaro Clinical Research Institute, Kilimanjaro, Tanzania
| | - R S Wallis
- The Aurum Institute, Tembisa, South Africa
| | - M Sebe
- The Aurum Institute, Tembisa, South Africa
| | - F A Mhimbira
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | - B Mbeya
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | - M Rassool
- Clinical HIV Research Unit, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, Helen Joseph Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - L Geiter
- LegoChem Biosciences, Daejeon, South Korea
| | - Y L Cho
- LegoChem Biosciences, Daejeon, South Korea
| | - N Heinrich
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Munich, Germany.
- German Center for Infection Research (DZIF), Munich partner site, Munich, Germany.
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5
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Hoffmann L, Coras R, Kobow K, López-Rivera JA, Lal D, Leu C, Najm I, Nürnberg P, Herms J, Harter PN, Bien CG, Kalbhenn T, Müller M, Pieper T, Hartlieb T, Kudernatsch M, Hamer H, Brandner S, Rössler K, Blümcke I, Jabari S. Correction to: Ganglioglioma with adverse clinical outcome and atypical histopathological features were defined by alterations in PTPN11/KRAS/NF1 and other RAS-/MAP-Kinase pathway genes. Acta Neuropathol 2023; 145:851-855. [PMID: 37115209 PMCID: PMC10175382 DOI: 10.1007/s00401-023-02577-x] [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: 04/29/2023]
Affiliation(s)
- Lucas Hoffmann
- Department of Neuropathology, Partner of the European Reference Network (ERN) EpiCARE, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, 91054, Germany
| | - Roland Coras
- Department of Neuropathology, Partner of the European Reference Network (ERN) EpiCARE, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, 91054, Germany
| | - Katja Kobow
- Department of Neuropathology, Partner of the European Reference Network (ERN) EpiCARE, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, 91054, Germany
| | - Javier A López-Rivera
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, USA
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Dennis Lal
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA, 02142, USA
- Cologne Center for Genomics (CCG), Medical Faculty of the University of Cologne, University Hospital of Cologne, 50931, Cologne, Germany
| | - Costin Leu
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA, 02142, USA
- Cologne Center for Genomics (CCG), Medical Faculty of the University of Cologne, University Hospital of Cologne, 50931, Cologne, Germany
| | - Imad Najm
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Peter Nürnberg
- Cologne Center for Genomics (CCG), Medical Faculty of the University of Cologne, University Hospital of Cologne, 50931, Cologne, Germany
| | - Jochen Herms
- Center for Neuropathology and Prion Research, LMU Munich, Munich, Germany
| | - Patrick N Harter
- Center for Neuropathology and Prion Research, LMU Munich, Munich, Germany
| | - Christian G Bien
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, 33617, Germany
| | - Thilo Kalbhenn
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, 33617, Germany
- Department of Neurosurgery (Evangelisches Klinikum Bethel), Medical School, Bielefeld University, Bielefeld, 33617, Germany
| | - Markus Müller
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, 33617, Germany
| | - Tom Pieper
- Center for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schoen-Clinic, Vogtareuth, 83569, Rosenheim, Germany
| | - Till Hartlieb
- Center for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schoen-Clinic, Vogtareuth, 83569, Rosenheim, Germany
| | - Manfred Kudernatsch
- Center for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schoen-Clinic, Vogtareuth, 83569, Rosenheim, Germany
| | - Hajo Hamer
- Epilepsy Center, EpiCARE Partner, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, 91054, Germany
| | - Sebastian Brandner
- Department of Neurosurgery, EpiCARE Partner, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Karl Rössler
- Department of Neurosurgery, EpiCARE Partner, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
- Department of Neurosurgery, EpiCARE Partner, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Ingmar Blümcke
- Department of Neuropathology, Partner of the European Reference Network (ERN) EpiCARE, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, 91054, Germany
| | - Samir Jabari
- Department of Neuropathology, Partner of the European Reference Network (ERN) EpiCARE, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, 91054, Germany.
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6
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Hoffmann L, Coras R, Kobow K, López-Rivera JA, Lal D, Leu C, Najm I, Nürnberg P, Herms J, Harter PN, Bien CG, Kalbhenn T, Müller M, Pieper T, Hartlieb T, Kudernatsch M, Hamer H, Brandner S, Rössler K, Blümcke I, Jabari S. Ganglioglioma with adverse clinical outcome and atypical histopathological features were defined by alterations in PTPN11/KRAS/NF1 and other RAS-/MAP-Kinase pathway genes. Acta Neuropathol 2023; 145:815-827. [PMID: 36973520 PMCID: PMC10175344 DOI: 10.1007/s00401-023-02561-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/27/2023] [Accepted: 03/09/2023] [Indexed: 03/29/2023]
Abstract
Exome-wide sequencing studies recently described PTPN11 as a novel brain somatic epilepsy gene. In contrast, germline mutations of PTPN11 are known to cause Noonan syndrome, a multisystem disorder characterized by abnormal facial features, developmental delay, and sporadically, also brain tumors. Herein, we performed a deep phenotype-genotype analysis of a comprehensive series of ganglioglioma (GG) with brain somatic alterations of the PTPN11/KRAS/NF1 genes compared to GG with common MAP-Kinase signaling pathway alterations, i.e., BRAFV600E. Seventy-two GG were submitted to whole exome sequencing and genotyping and 84 low grade epilepsy associated tumors (LEAT) to DNA-methylation analysis. In 28 tumours, both analyses were available from the same sample. Clinical data were retrieved from hospital files including disease onset, age at surgery, brain localization, and seizure outcome. A comprehensive histopathology staining panel was available in all cases. We identified eight GG with PTPN11 alterations, copy number variant (CNV) gains of chromosome 12, and the commonality of additional CNV gains in NF1, KRAS, FGFR4 and RHEB, as well as BRAFV600E alterations. Histopathology revealed an atypical glio-neuronal phenotype with subarachnoidal tumor spread and large, pleomorphic, and multinuclear cellular features. Only three out of eight patients with GG and PTPN11/KRAS/NF1 alterations were free of disabling-seizures 2 years after surgery (38% had Engel I). This was remarkably different from our series of GG with only BRAFV600E mutations (85% had Engel I). Unsupervised cluster analysis of DNA methylation arrays separated these tumours from well-established LEAT categories. Our data point to a subgroup of GG with cellular atypia in glial and neuronal cell components, adverse postsurgical outcome, and genetically characterized by complex alterations in PTPN11 and other RAS-/MAP-Kinase and/or mTOR signaling pathways. These findings need prospective validation in clinical practice as they argue for an adaptation of the WHO grading system in developmental, glio-neuronal tumors associated with early onset focal epilepsy.
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Affiliation(s)
- Lucas Hoffmann
- Department of Neuropathology, Partner of the European Reference Network (ERN) EpiCARE, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, 91054, Germany
| | - Roland Coras
- Department of Neuropathology, Partner of the European Reference Network (ERN) EpiCARE, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, 91054, Germany
| | - Katja Kobow
- Department of Neuropathology, Partner of the European Reference Network (ERN) EpiCARE, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, 91054, Germany
| | - Javier A López-Rivera
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, USA
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Dennis Lal
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA, 02142, USA
- Cologne Center for Genomics (CCG), Medical Faculty of the University of Cologne, University Hospital of Cologne, 50931, Cologne, Germany
| | - Costin Leu
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA, 02142, USA
- Cologne Center for Genomics (CCG), Medical Faculty of the University of Cologne, University Hospital of Cologne, 50931, Cologne, Germany
| | - Imad Najm
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Peter Nürnberg
- Cologne Center for Genomics (CCG), Medical Faculty of the University of Cologne, University Hospital of Cologne, 50931, Cologne, Germany
| | - Jochen Herms
- Center for Neuropathology and Prion Research, LMU Munich, Munich, Germany
| | - Patrick N Harter
- Center for Neuropathology and Prion Research, LMU Munich, Munich, Germany
| | - Christian G Bien
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, 33617, Germany
| | - Thilo Kalbhenn
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, 33617, Germany
- Department of Neurosurgery (Evangelisches Klinikum Bethel), Medical School, Bielefeld University, Bielefeld, 33617, Germany
| | - Markus Müller
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, 33617, Germany
| | - Tom Pieper
- Center for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schoen-Clinic, Vogtareuth, 83569, Rosenheim, Germany
| | - Till Hartlieb
- Center for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schoen-Clinic, Vogtareuth, 83569, Rosenheim, Germany
| | - Manfred Kudernatsch
- Center for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schoen-Clinic, Vogtareuth, 83569, Rosenheim, Germany
| | - Hajo Hamer
- Epilepsy Center, EpiCARE Partner, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, 91054, Germany
| | - Sebastian Brandner
- Department of Neurosurgery, EpiCARE Partner, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Karl Rössler
- Department of Neurosurgery, EpiCARE Partner, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
- Department of Neurosurgery, EpiCARE Partner, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Ingmar Blümcke
- Department of Neuropathology, Partner of the European Reference Network (ERN) EpiCARE, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, 91054, Germany
| | - Samir Jabari
- Department of Neuropathology, Partner of the European Reference Network (ERN) EpiCARE, Universitätsklinikum Erlangen, FAU Erlangen-Nürnberg, Erlangen, 91054, Germany.
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7
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Hoffmann L, Danne F, Weiss K, Photiadis J, Schleiger A, Sallmon H, Berger F, Ovroutski S, Kramer P. Longitudinal Somatic Growth in Patients with Complex Univentricular Heart Disease Undergoing Fontan Operation: Relation to Suboptimal Outcomes. Thorac Cardiovasc Surg 2023. [DOI: 10.1055/s-0043-1761843] [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: 03/22/2023]
Affiliation(s)
- L. Hoffmann
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - F. Danne
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - K. Weiss
- Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - J. Photiadis
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - A. Schleiger
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - H. Sallmon
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - F. Berger
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - S. Ovroutski
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
| | - P. Kramer
- Deutsches Herzzentrum Berlin, Berlin, Deutschland
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8
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Tvilum M, Lutz C, Hoffmann L, Khalil A, Appelt A, Alber M, Grau C, Schmidt H, Kandi M, Haraldsen A, Mortensen L, Holt M, Knap M, Moller D. Prognostic Image Biomarkers in the Treatment of Patients with Locally Advanced NSCLC. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1551] [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: 10/31/2022]
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9
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López-Rivera JA, Leu C, Macnee M, Khoury J, Hoffmann L, Coras R, Kobow K, Bhattarai N, Pérez-Palma E, Hamer H, Brandner S, Rössler K, Bien CG, Kalbhenn T, Pieper T, Hartlieb T, Butler E, Genovese G, Becker K, Altmüller J, Niestroj LM, Ferguson L, Busch RM, Nürnberg P, Najm I, Blümcke I, Lal D. The genomic landscape across 474 surgically accessible epileptogenic human brain lesions. Brain 2022; 146:1342-1356. [PMID: 36226386 PMCID: PMC10115236 DOI: 10.1093/brain/awac376] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [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: 02/16/2022] [Revised: 08/11/2022] [Accepted: 10/12/2022] [Indexed: 11/12/2022] Open
Abstract
Understanding the exact molecular mechanisms involved in the etiology of epileptogenic pathologies with or without tumor activity is essential for improving treatment of drug-resistant focal epilepsy. Here, we characterize the landscape of somatic genetic variants in resected brain specimens from 474 individuals with drug-resistant focal epilepsy using deep whole-exome sequencing (>350×) and whole-genome genotyping. Across the exome, we observe a greater number of somatic single-nucleotide variants (SNV) in low-grade epilepsy-associated tumors (LEAT; 7.92 ± 5.65 SNV) than in brain tissue from malformations of cortical development (MCD; 6.11 ± 4 SNV) or hippocampal sclerosis (HS; 5.1 ± 3.04 SNV). Tumor tissues also had the largest number of likely pathogenic variant carrying cells. LEAT had the highest proportion of samples with one or more somatic copy number variants (CNV; 24.7%), followed by MCD (5.4%) and HS (4.1%). Recurring somatic whole chromosome duplications affecting Chromosome 7 (16.8%), chromosome 5 (10.9%), and chromosome 20 (9.9%) were observed among LEAT. For germline variant-associated MCD genes such as TSC2, DEPDC5, and PTEN, germline SNV were frequently identified within large loss of heterozygosity regions, supporting the recently proposed 'second hit' disease mechanism in these genes. We detect somatic variants in twelve established lesional epilepsy genes and demonstrate exome-wide statistical support for three of these in the etiology of LEAT (e.g., BRAF) and MCD (e.g., SLC35A2 and MTOR). We also identify novel significant associations for PTPN11 with LEAT and NRAS Q61 mutated protein with a complex MCD characterized by polymicrogyria and nodular heterotopia. The variants identified in NRAS are known from cancer studies to lead to hyperactivation of NRAS, which can be targeted pharmacologically. We identify large recurrent 1q21-q44 duplication including AKT3 in association with focal cortical dysplasia type 2a with hyaline astrocytic inclusions, another rare and possibly under-recognized brain lesion. The clinical genetic analyses showed that the numbers of somatic SNV across the exome and the fraction of affected cells were positively correlated with the age at seizure onset and surgery in individuals with LEAT. In summary, our comprehensive genetic screen sheds light on the genome-scale landscape of genetic variants in epileptic brain lesions, informs the design of gene panels for clinical diagnostic screening, and guides future directions for clinical implementation of epilepsy surgery genetics.
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Affiliation(s)
- Javier A López-Rivera
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, USA.,Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Costin Leu
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA.,Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA 02142, USA.,Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK
| | - Marie Macnee
- Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany
| | - Jean Khoury
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Lucas Hoffmann
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany, and partner of the European Reference Network (ERN) EpiCARE
| | - Roland Coras
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany, and partner of the European Reference Network (ERN) EpiCARE
| | - Katja Kobow
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany, and partner of the European Reference Network (ERN) EpiCARE
| | - Nisha Bhattarai
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Eduardo Pérez-Palma
- Universidad del Desarrollo, Centro de Genética y Genómica, Facultad de Medicina Clínica Alemana. Santiago 7610658, Chile
| | - Hajo Hamer
- Epilepsy Center, University Hospital Erlangen, Erlangen, Germany, and EpiCARE partner
| | - Sebastian Brandner
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany, and EpiCARE partner
| | - Karl Rössler
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria, and EpiCARE partner
| | - Christian G Bien
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany
| | - Thilo Kalbhenn
- Department of Neurosurgery - Epilepsy surgery, Evangelisches Klinikum Bethel, Universitätsklinikum OWL, Bielefeld University, Bielefeld, Germany
| | - Tom Pieper
- Center for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schoen-Clinic, Vogtareuth, Germany
| | - Till Hartlieb
- Center for Pediatric Neurology, Neurorehabilitation, and Epileptology, Schoen-Clinic, Vogtareuth, Germany.,Research Institute "Rehabilitation, Transition, Palliation", PMU Salzburg, Salzburg, Austria
| | - Elizabeth Butler
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Giulio Genovese
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA 02142, USA
| | - Kerstin Becker
- Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany
| | - Janine Altmüller
- Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Core Facility Genomics, Charitéplatz 1, 10117 Berlin, Germany.,Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Lisa Marie Niestroj
- Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany
| | - Lisa Ferguson
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Robyn M Busch
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Peter Nürnberg
- Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany
| | - Imad Najm
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA
| | - Ingmar Blümcke
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA.,Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany, and partner of the European Reference Network (ERN) EpiCARE
| | - Dennis Lal
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, USA.,Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T, Cambridge, MA 02142, USA.,Cologne Center for Genomics (CCG), University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931 Cologne, Germany
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10
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Bernard M, Hoffmann L, Gebhard B, Völlm C, Fink A, Richter M. Entwicklung und psychometrische Testung eines
Partizipationsmessinstruments für Jugendliche mit und ohne
körperlich-motorische Beeinträchtigungen und/oder
chronische Erkrankungen – Ergebnisse der PartJu
Pilotstudie. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753606] [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: 12/12/2022]
Affiliation(s)
- M Bernard
- Martin-Luther Universität Halle-Wittenberg, Institut
für Medizinische Soziologie, Halle, Deutschland
| | - L Hoffmann
- Martin-Luther Universität Halle-Wittenberg, Institut
für Medizinische Soziologie, Halle, Deutschland
| | - B Gebhard
- Fachhoschule Südwestfalen, Fachbereich Bildungs- und
Gesellschaftswissenschaften, Soest, Deutschland
| | - C Völlm
- Fachhoschule Südwestfalen, Fachbereich Bildungs- und
Gesellschaftswissenschaften, Soest, Deutschland
| | - A Fink
- Kreis Groß-Gerau, Abteilung für Gesundheit und
Verbraucherschutz, Groß-Gerau, Deutschland
| | - M Richter
- Technische Universität München, Department of Sport and
Health Sciences, München, Deutschland
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11
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Hoffmann L, Bernard M, Gebhard B, Völlm C, Fink A, Richter M. PartJu: Ergebnisse zur Konzeptualisierung von sozialer Partizipation
von Jugendlichen mit und ohne körperlich-motorischen
Beeinträchtigungen und/oder chronischen
Erkrankungen. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753785] [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: 12/12/2022]
Affiliation(s)
- L Hoffmann
- Martin-Luther Universität Halle-Wittenberg, Institut
für Medizinische Soziologie, Halle, Deutschland
| | - M Bernard
- Martin-Luther Universität Halle-Wittenberg, Institut
für Medizinische Soziologie, Halle, Deutschland
| | - B Gebhard
- Fachhochschule Südwestfalen, Fachbereich Bildungs- und
Gesellschaftswissenschaften, Soest, Deutschland
| | - C Völlm
- Fachhochschule Südwestfalen, Fachbereich Bildungs- und
Gesellschaftswissenschaften, Soest, Deutschland
| | - A Fink
- Kreis Groß-Gerau, Abteilung für Gesundheit und
Verbraucherschutz, Groß-Gerau, Deutschland
| | - M Richter
- Technische Universität München, Department of Sport and
Health Sciences, München, Deutschland
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12
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Ahlmann S, Hoffmann L, Keppler M, Münzner P, Tonauer CM, Loerting T, Gainaru C, Böhmer R. Isotope effects on the dynamics of amorphous ices and aqueous phosphoric acid solutions. Phys Chem Chem Phys 2022; 24:14846-14856. [PMID: 35697341 DOI: 10.1039/d2cp01455f] [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: 11/21/2022]
Abstract
The glass transitions of amorphous ices as well as of aqueous phosphoric acid solutions were reported to display very large 1H/2H isotope effects. Using dielectric spectroscopy, in both types of glassformers for equimolar protonated/deuterated mixtures an almost ideal isotope-mixing behavior rather than a bimodal relaxation is found. For the amorphous ices this finding is interpreted in terms of a glass-to-liquid rather than an orientational glass transition scenario. Based on calorimetric results revealing that major 16O/18O isotope effects are missing, the latter scenario was previously favored for the amorphous ices. Considering the dielectric results on 18O substituted amorphous ices and by comparison with corresponding results for the aqueous phosphoric acid solutions, it is argued that the present findings are compatible with the glass-to-liquid scenario. To provide additional information regarding the deeply supercooled state of 1H/2H isotopically mixed and 18O substituted glassformers, the aqueous phosphoric acid solutions are studied using shear mechanical spectroscopy as well, a technique which so far could not successfully be applied to characterize the glass transitions of the amorphous ices.
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Affiliation(s)
- S Ahlmann
- Fakultät Physik, Technische Universität Dortmund, 44221 Dortmund, Germany
| | - L Hoffmann
- Fakultät Physik, Technische Universität Dortmund, 44221 Dortmund, Germany
| | - M Keppler
- Fakultät Physik, Technische Universität Dortmund, 44221 Dortmund, Germany
| | - P Münzner
- Fakultät Physik, Technische Universität Dortmund, 44221 Dortmund, Germany
| | - C M Tonauer
- Institute of Physical Chemistry, University of Innsbruck, Innrain 52c, A-6020 Innsbruck, Austria
| | - T Loerting
- Institute of Physical Chemistry, University of Innsbruck, Innrain 52c, A-6020 Innsbruck, Austria
| | - C Gainaru
- Fakultät Physik, Technische Universität Dortmund, 44221 Dortmund, Germany.,Chemical Sciences Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - R Böhmer
- Fakultät Physik, Technische Universität Dortmund, 44221 Dortmund, Germany
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13
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Rasmussen A, Møller D, Hoffmann L, Knap M, Schmidt H, Ehmsen M, Ravkilde T, Worm E, Andersen M. PD-0653 Reproducibility of deep inspiration breath hold during RT for lung cancer patients. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02900-0] [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: 11/16/2022]
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14
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Thomsen S, Møller D, Knap M, Khalil A, Nyeng T, Hoffmann L. PD-0399 Daily delivered dose in NSCLC patients receiving dose escalation. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02834-1] [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: 10/18/2022]
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15
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Rohrer S, Møller D, Hoffmann L, Skouboe S, Ehmsen M, Ravkilde T, Knap M, Poulsen P. MO-0470 Markerless lung tumor localization in cine MV images of deep-inspiration breath-hold IMRT treatments. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02364-7] [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: 11/26/2022]
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16
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Shamshad M, Sloth Møller D, Mortensen H, Lykkegaard Ehmsen M, Fuglsang Jensen M, Hoffmann L. PO-1508 Bone versus soft tissue setup in proton therapy for patients with oesophageal cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03472-7] [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: 11/28/2022]
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17
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Lutz C, Møller D, Appelt A, Alber M, Hoffmann L, Khalil A, Holt M, Kandi M, Schmidt H, Tvilum M, Knap M. PD-0664 Risk factors of radiation pneumonitis in modern adaptive radiotherapy. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02911-5] [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: 10/18/2022]
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18
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Tvilum M, Knap M, Lutz C, Hoffmann L, Khalil A, Haraldsen A, Alber M, Grau C, Schmidt H, Kandi M, Mortensen L, Holt M, Appelt A, Moeller D. PO-1262 Early response to chemotherapy as predictor of locoregional and distant failure in NSCLC. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03226-1] [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: 10/18/2022]
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19
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Hoffmann L, Blümcke I. Neuropathology and epilepsy surgery. Curr Opin Neurol 2022; 35:202-207. [PMID: 35067500 DOI: 10.1097/wco.0000000000001030] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Neurosurgical treatment of patients suffering from drug-resistant focal epilepsy is recognized as a successful, yet underutilized medical treatment option. By searching PubMed for articles published between January 2020 and September 2021 with the broad search terms 'neuropathology' AND 'epilepsy surgery', this review highlights the active field of etiology-based epilepsy research in human tissue. RECENT FINDINGS All papers addressing the most common epileptogenic human brain disease entities, i.e. focal cortical dysplasia (FCD), brain tumors or hippocampal sclerosis, and written in English language were eligible for our review. We can conclude from this review that etiology-based studies are of foremost interest for (1) the development of prediction models for postsurgical seizure outcome; (2) decipher genetic and molecular alterations to better define disease entities and underlying molecular pathomechanisms, and (3) the translation of human tissue-derived biomarker into clinically useful diagnostics or novel therapeutic targets in the near future. SUMMARY Highlighting FCD brain somatic gain-of-function variants in mammalian target of Rapamycin are a leading pathway to better classify FCD. An integrated genotype-phenotype analysis enables to classify the broad spectrum of low-grade and epilepsy-associated brain tumors. Further DNA-methylation-based disease classification will increase the mechanistic understanding and diagnostic precision of difficult to classify pathologies in the future.
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Affiliation(s)
- Lucas Hoffmann
- Department of Neuropathology, University Hospital Erlangen, Erlangen, Germany
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Hoffmann L, Persson G, Nygård L, Nielsen T, Borrisova S, Gaard-Petersen F, Josipovic M, Khalil A, Kjeldsen R, Knap M, Kristiansen C, Møller D, Ottosson W, Sand H, Thing R, Pøhl M, Schytte T. Thorough design and pre-trial quality assurance (QA) decrease dosimetric impact of delineation and dose planning variability in the STRICTLUNG and STARLUNG trials for stereotactic body radiotherapy (SBRT) of central and ultra-central lung tumours. Radiother Oncol 2022; 171:53-61. [DOI: 10.1016/j.radonc.2022.04.005] [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] [Received: 07/01/2021] [Revised: 03/28/2022] [Accepted: 04/05/2022] [Indexed: 10/18/2022]
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Jablonski J, Hoffmann L, Blümcke I, Fejtová A, Uebe S, Ekici AB, Gnatkovsky V, Kobow K. Experimental Epileptogenesis in a Cell Culture Model of Primary Neurons from Rat Brain: A Temporal Multi-Scale Study. Cells 2021; 10:cells10113004. [PMID: 34831225 PMCID: PMC8616120 DOI: 10.3390/cells10113004] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/27/2021] [Accepted: 11/02/2021] [Indexed: 12/24/2022] Open
Abstract
Understanding seizure development requires an integrated knowledge of different scales of organization of epileptic networks. We developed a model of “epilepsy-in-a-dish” based on dissociated primary neuronal cells from neonatal rat hippocampus. We demonstrate how a single application of glutamate stimulated neurons to generate spontaneous synchronous spiking activity with further progression into spontaneous seizure-like events after a distinct latency period. By computational analysis, we compared the observed neuronal activity in vitro with intracranial electroencephalography (EEG) data recorded from epilepsy patients and identified strong similarities, including a related sequence of events with defined onset, progression, and termination. Next, a link between the neurophysiological changes with network composition and cellular structure down to molecular changes was established. Temporal development of epileptiform network activity correlated with increased neurite outgrowth and altered branching, increased ratio of glutamatergic over GABAergic synapses, and loss of calbindin-positive interneurons, as well as genome-wide alterations in DNA methylation. Differentially methylated genes were engaged in various cellular activities related to cellular structure, intracellular signaling, and regulation of gene expression. Our data provide evidence that a single short-term excess of glutamate is sufficient to induce a cascade of events covering different scales from molecule- to network-level, all of which jointly contribute to seizure development.
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Affiliation(s)
- Janos Jablonski
- Department of Neuropathology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (J.J.); (L.H.); (I.B.)
| | - Lucas Hoffmann
- Department of Neuropathology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (J.J.); (L.H.); (I.B.)
| | - Ingmar Blümcke
- Department of Neuropathology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (J.J.); (L.H.); (I.B.)
| | - Anna Fejtová
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
| | - Steffen Uebe
- NGS Core Unit, Institute of Human Genetics, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (S.U.); (A.B.E.)
| | - Arif B. Ekici
- NGS Core Unit, Institute of Human Genetics, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (S.U.); (A.B.E.)
| | - Vadym Gnatkovsky
- Department of Epileptology, University Hospital Bonn, 53127 Bonn, Germany;
| | - Katja Kobow
- Department of Neuropathology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (J.J.); (L.H.); (I.B.)
- Correspondence: ; Tel.: +49-9131-8522859
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Schulte-Hubbert F, Drummer D, Hoffmann L. Model Approach for Displaying Dynamic Filament Displacement during Impregnation of Continuous Fibres Based on the Theory of Similarity – Theory and Modelling. INT POLYM PROC 2021. [DOI: 10.1515/ipp-2020-4020] [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: 11/15/2022]
Abstract
Abstract
The underlying process for the production of textile reinforced thermoplastics is the impregnation of dry textile reinforcements with a thermoplastic matrix. The process parameters such as temperature, time and pressure of the impregnation are mainly determined by the permeability of the reinforcement. This results from a complex interaction of hydrodynamic compaction and relaxation behavior caused by textile and process parameters. The foundation for the description and optimization of impregnation progresses is therefore the determination of the pressure-dependent permeability of fibre textiles. Previous experimental investigations have shown that the dynamic compaction behavior during the impregnation of fibre reinforcements with thermoplastics or thermosets can be successfully characterized. However, for most cases, an analytical representation has not been possible due to the complexity of the process. Although it may be possible to reproduce this behavior by numerical calculations, the results need to be confirmed by experiments. This paper lays the analytical foundation for building a scaled model system, based on the theory of similarity, to observe, measure, and evaluate the dynamic compaction behavior of textile reinforcements under controlled process conditions.
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Affiliation(s)
| | - D. Drummer
- Lehrstuhl für Kunststofftechnik FAU Erlangen-Nürnberg , Erlangen , Germany
| | - L. Hoffmann
- Neue Materialien Fürth GmbH , Fürth , Germany
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Milo M, Møller D, Nyeng T, Hoffmann L, Jensen I, Nissen H, Lorenzen E, Nielsen K, Thorsen L, Johnsen S, Alsner J, Offersen B. OC-0558 No correlation between mean heart dose and coronary stenosis in 17,088 DBCG breast cancer patients. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06965-6] [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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Hoffmann L, Poulsen P, Nordsmark M, Hegener A, Ehmsen M, Nyeng T, Lutz C, Ravkilde T, Bertholet J, Kruhlikava I, Dufour M, Mortensen H, Alber M, Møller D. SP-0684 How to deal with respiratory and cardiac movement? Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08667-9] [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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Hoffmann L, Mortensen H, Berbee M, Bizzocchi N, Bütof R, Canters R, Defraene G, Ehmsen M, Freixas G, Haustermans K, Korevaar E, Makocki S, Muijs C, Nordsmark M, Thomas M, Troost E, Visser S, Weber D, Møller D. OC-0631 Proton and photon treatment planning comparison for oesophageal cancer between six European centres. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06987-5] [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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Khalil AA, Knap MM, Møller DS, Nyeng TB, Kjeldsen R, Hoffmann L. Local control after stereotactic body radiotherapy of centrally located lung tumours. Acta Oncol 2021; 60:1069-1073. [PMID: 33988493 DOI: 10.1080/0284186x.2021.1914345] [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: 10/21/2022]
Affiliation(s)
- A. A. Khalil
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark
| | - M. M. Knap
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark
| | - D. S. Møller
- Department of Medical Physics, Aarhus University Hospital, Aarhus N, Denmark
| | - T. B. Nyeng
- Department of Medical Physics, Aarhus University Hospital, Aarhus N, Denmark
| | - R. Kjeldsen
- Department of Oncology, Aalborg University Hospital, Aarhus N, Denmark
| | - L. Hoffmann
- Department of Medical Physics, Aarhus University Hospital, Aarhus N, Denmark
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Lutz C, Knap M, Møller D, Hoffmann L, Khalil A, Håkansson K, Persson G, Bentzen S, Nygård L, Vogelius I. PD-0876 First-failure prediction model for locally advanced non-small cell lung cancer - External validation. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07155-3] [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: 11/28/2022]
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Milo M, Nyeng T, Lorenzen E, Hoffmann L, Møller D, Offersen B. PO-1710 Atlas-based auto-segmentation for delineating the heart and cardiac substructures radiation therapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08161-5] [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: 11/28/2022]
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Hoffmann L, Knap MM, Alber M, Møller DS. Optimal beam angle selection and knowledge-based planning significantly reduces radiotherapy dose to organs at risk for lung cancer patients. Acta Oncol 2021; 60:293-299. [PMID: 33306422 DOI: 10.1080/0284186x.2020.1856409] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 12/25/2022]
Abstract
BACKGROUND Lung cancer patients struggle with high toxicity rates. This study investigates if IMRT plans with individually set beam angles or uni-lateral VMAT plans results in dose reduction to OARs. We investigate if introduction of a RapidPlan model leads to reduced dose to OARs. Finally, the model is validated prospectively. MATERIAL AND METHODS Seventy-four consecutive lung cancer patients treated with IMRT were included. For all patients, new IMRT plans were made by an experienced dose planner re-tuning beam angles aiming for minimized dose to the lungs and heart. Additionally, VMAT plans were made. The IMRT plans were selected as input for a RapidPlan model, which was used to generate 74 new IMRT plans. The new IMRT plans were used as input for a second RapidPlan model. This model was clinically implemented and used for generation of clinical treatment plans. Dosimetric parameters were compared using a Wilcoxon signed rank test or a 1-sided student's t-test. p < .05 was considered significant. RESULTS IMRT plans significantly reduced mean doses to lungs (MLD) and heart (MHD) by 1.6 Gy and 1.7 Gy in mean compared to VMAT plans. MLD was significantly (p < .001) reduced from 10.8 Gy to 9.4 Gy by using the second RapidPlan model. MHD was significantly (p < .001) reduced from 4.9 Gy to 3.9 Gy. The model was validated in prospectively collected treatment plans showing significantly lower MLD after the implementation of the second RapidPlan model. CONCLUSION Introduction of RapidPlan and beam angles selected based on the target and OARs position reduces dose to OARs.
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Affiliation(s)
- L. Hoffmann
- Department of Oncology, Section for Medical Physics, Aarhus University Hospital, Aarhus, Denmark
| | - M. M. Knap
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - M. Alber
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - D. S. Møller
- Department of Oncology, Section for Medical Physics, Aarhus University Hospital, Aarhus, Denmark
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Nyeng TB, Møller DS, Farr K, Kramer S, Khalil AA, Grau C, Hoffmann L. A comparison of two methods for segmentation of functional volumes in radiotherapy planning of lung cancer patients. Acta Oncol 2021; 60:353-360. [PMID: 33522851 DOI: 10.1080/0284186x.2021.1877811] [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: 10/22/2022]
Abstract
BACKGROUND In radiotherapy (RT) of lung cancer, dose to functional lung (FL) volumes segmented with two different methods (perfusion SPECT (Q-SPECT) and 4D-CT (4D) ventilation (V)) have been shown to correlate with the incidence of radiation pneumonitis (RP). This study aims to compare the FL volumes identified by both methods. MATERIAL AND METHODS Thirty lung cancer patients had a 4D and Q-SPECT prior to treatment. Seventeen of these patients also had a ventilation SPECT (V-SPECT). FL sub-volumes were segmented automatically, using cut-off values. The volumes were compared in terms of overlap fraction (OF) relative to the minimal volume, and intersection fraction (IF) of the FL volume relative to the total lung volume (VLung). RESULTS Cut-off values suggested in literature for Q-SPECT and 4D-V resulted in volumes differing in size by a median 18% [6%;31%], and a median OF and IF of 0.48 [0.23;0.70] and 0.09 [0.02;0.25], respectively. Segmenting volumes of comparable size of about 1/3 of VLung (FL-m(1/3), m = method) resulted in a median OF and IF of 0.43 [0.23;0.58] and 0.12 [0.06;0.19], respectively. Twenty-five patients (83%) had a reasonable overlap between FL-Q(1/3) and FL-4D-V(1/3) volumes, with OF values above 0.33. IF increased significantly (p = .036) compared to using fixed cut-off values. Similarly, volumes of comparable size of about 1/3 VLung were produced for V-SPECT, and FL-Q(1/3), FL-V(1/3), and FL-4D-V(1/3) were compared. The overlaps and intersections of FL-V(1/3) with FL-Q(1/3) volumes were significantly (p<.001) larger than the corresponding overlaps and intersections of FL-Q(1/3) with FL-4D(1/3) and FL-V(1/3) with FL-4D(1/3). CONCLUSION The Q-SPECT and 4D-V methods do not segment entirely the same FL volumes. A reasonable overlap of the volumes along with the findings of other studies that both correlate to RP incidence, suggests that a combination of both volumes, e.g. using the IF, may be useful in RT treatment planning.
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Affiliation(s)
- T. B. Nyeng
- Department of Oncology, Section for Medical Physics, Aarhus University Hospital, Aarhus, Denmark
| | - D. S. Møller
- Department of Oncology, Section for Medical Physics, Aarhus University Hospital, Aarhus, Denmark
| | - K. Farr
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - S. Kramer
- Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Aarhus, Denmark
| | - A. A. Khalil
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - C. Grau
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - L. Hoffmann
- Department of Oncology, Section for Medical Physics, Aarhus University Hospital, Aarhus, Denmark
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Cabral BCA, Hoffmann L, Bottaro T, Costa PF, Ramos ALA, Coelho HSM, Villela-Nogueira CA, Ürményi TP, Faffe DS, Silva R. Circulating microRNAs associated with liver fibrosis in chronic hepatitis C patients. Biochem Biophys Rep 2020; 24:100814. [PMID: 33015376 PMCID: PMC7520427 DOI: 10.1016/j.bbrep.2020.100814] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 08/02/2020] [Revised: 09/06/2020] [Accepted: 09/14/2020] [Indexed: 12/21/2022] Open
Abstract
A major challenge in hepatitis C research is the detection of early potential for progressive liver disease. MicroRNAs (miRNAs) are small RNAs that regulate gene expression and can be biomarkers of pathological processes. In this study, we compared circulating miRNAs identified in hepatitis C virus (HCV)-infected patients presenting two extremes of liver disease: mild/moderate fibrosis and cirrhosis. The patients in the cirrhosis group subsequently developed hepatocellular carcinoma (HCC). We identified 163 mature miRNAs in the mild/moderate fibrosis group and 171 in the cirrhosis group, with 144 in common to both groups. Differential expression analysis revealed 5 upregulated miRNAs and 2 downregulated miRNAs in the cirrhosis group relative to the mild/moderate fibrosis group. Functional analyses of regulatory networks (target gene and miRNA) identified gene categories involved in cell cycle biological processes and metabolic pathways related to cell cycle, cancer, and apoptosis. These results suggest that the differentially expressed circulating miRNAs observed in this work (miR-215-5p, miR-483-5p, miR-193b-3p, miR-34a-5p, miR-885-5p, miR-26b-5p and miR -197-3p) may be candidates for biomarkers in the prognosis of liver disease. Circulating miRNome was performed in patients infected with HCV-1a or 1b. Mature miRNAs were identified in patients with mild/moderate fibrosis and cirrhosis. Five upregulated and two downregulated miRNAs were observed in the cirrhosis group. Regulatory networks identified gene categories involved in cell cycle. A routine baseline circulating biomarkers detection can have a prognostic value.
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Affiliation(s)
- B C A Cabral
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - L Hoffmann
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Departamento de Biotecnologia, Instituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - T Bottaro
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - P F Costa
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - A L A Ramos
- Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - H S M Coelho
- Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - C A Villela-Nogueira
- Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - T P Ürményi
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - D S Faffe
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - R Silva
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Møller DS, Schmidt M, Ravkilde T, Poulsen P, Hansen J, Worm E, Schmidt H, Knap M, Safwat A, Rose H, Hoffmann L. PO-0974 Intra-fractional stability of Deep Inspiration Breath Hold during RT for lung and lymphoma cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31394-5] [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: 11/26/2022]
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Byskov CS, Holm AIS, Korreman S, Hoffmann L, Nordsmark M, Møller DS. PO-0944 Proton therapy for esophageal cancer; variable relative biological effect and heart dose. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31364-7] [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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Hoffmann L, Knap M, Møller D. PO-0920 Knowledge-based planning significantly reduces dose to organs at risk for lung cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31340-4] [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: 10/26/2022]
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Persson G, Schytte T, Appelt A, Borissova S, Brink C, Hansen T, Hoffmann L, Josipovic M, Khalil A, Knap M, Lund M, Lutz C, Møller D, Nielsen T, Nielsen M, Ottosson W, Pøhl M, Thomsen J, Hansen O. EP-1352 Locally advanced NSCLC: performance status based eligibility for adjuvant check point inhibitor. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31772-4] [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: 11/25/2022]
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Nyeng T, Hoffmann L, Farr K, Khalil A, Grau C, Møller D. PV-0313 Ventilation functional lung volumes obtained from SPECT and 4D-CT do not identify the same voxels. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30733-9] [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: 11/26/2022]
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Mortensen H, Nordsmark M, Møller D, Risum S, Holtved E, Nielsen M, Weber B, Josipovic M, Hoffmann L. PO-0807 Heterogeneous FDG-guided dose escalation in definitive oesophageal radiotherapy: a feasibility study. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31227-7] [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: 11/25/2022]
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Jensen MF, Hoffmann L, Petersen JBB, Møller DS, Alber M. Energy layer optimization strategies for intensity-modulated proton therapy of lung cancer patients. Med Phys 2018; 45:4355-4363. [PMID: 30129041 DOI: 10.1002/mp.13139] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 08/06/2018] [Accepted: 08/13/2018] [Indexed: 11/07/2022] Open
Abstract
PURPOSE When treating lung cancer patients with intensity-modulated proton therapy (IMPT), target coverage can only be guaranteed when utilizing motion mitigation. The three motion mitigation techniques, gating, breath-hold, and dose repainting, all benefit from a more rapid application of the treatment plan. A lower limit for the ungated treatment time is defined by the number of energy layers in the IMPT plan. By limiting this number during treatment planning, IMPT could become more viable for lung cancer patients. We investigate to what extend the number of layers can be reduced in single-field optimization (SFO) and multifield optimization (MFO) plans and which implications it has on the plan quality and robustness. METHODS We have implemented three distinct layer-reducing strategies in the treatment planning system Hyperion; constant energy steps, exponential energy steps, and an adaptive strategy, where the spot weights are exposed to a group sparsity penalty in combination with layer exclusion during optimization. Four levels of increasing layer removal are planned for each strategy. SFO and MFO plans with three treatment fields are created for eleven locally advanced NSCLC patients on the midventilation 4DCT phase to simulate a breath-hold. A minimum dose to the target is ensured for each degree of layer reduction, reflecting the plan quality in the homogeneity index (HI). Plan quality was also assessed by a robustness evaluation, where the patient setup was shifted 2 mm or 4 mm in six directions. RESULTS The three strategies result in very similar target coverages and robustness levels as a function of removed layers. The HI increases unacceptably for all the SFO plans after 50% layer removal as compared to the reference plan, while all the MFO plans are clinically acceptable with up to a highest removed percentage of 75%. The robustness level is constant as a function of removed layers. The SFO plans are significantly more robust than the MFO plans with all P-values below 0.001 (Wilcoxon signed-rank). The overall mean D98% CTV dose difference is at 2-mm setup error amplitude: 0.7 Gy (SFO) and 1.9 Gy (MFO), and at 4 mm: 3.2 Gy (SFO) and 5.4 Gy (MFO), respectively. CONCLUSIONS The number of layers in MFO plans can be reduced substantially more than in SFO plans without compromising plan quality. Furthermore, as the robustness is independent of the number of layers, it follows that if the level of robustness is acceptable or enforced via robust optimization, MFO plans could be candidates for treatment time reductions via energy layer reductions.
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Affiliation(s)
- M Fuglsang Jensen
- Danish Centre for Particle Therapy, Aarhus University Hospital, 8200, Aarhus N, Denmark.,Department of Oncology, Aarhus University Hospital, 8200, Aarhus N, Denmark
| | - L Hoffmann
- Department of Oncology, Aarhus University Hospital, 8200, Aarhus N, Denmark
| | - J B B Petersen
- Department of Oncology, Aarhus University Hospital, 8200, Aarhus N, Denmark
| | - D S Møller
- Department of Oncology, Aarhus University Hospital, 8200, Aarhus N, Denmark
| | - M Alber
- Department of Radiation Oncology, Heidelberg University Hospital, 69120, Heidelberg, Germany
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Hoffmann L, Mlinarić M, Buchenauer L, Kunst A, Richter M. Tabakkontrollpolitiken auf lokaler Ebene in 7 europäischen Ländern – Eine qualitative Studie aus Expertenperspektive. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1668010] [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]
Affiliation(s)
- L Hoffmann
- Martin- Luther- Universität Halle- Wittenberg, Institut für Medizinische Soziologie, Halle (Saale), Deutschland
| | - M Mlinarić
- Martin- Luther- Universität Halle- Wittenberg, Institut für Medizinische Soziologie, Halle (Saale), Deutschland
| | - L Buchenauer
- Martin- Luther- Universität Halle- Wittenberg, Institut für Medizinische Soziologie, Halle (Saale), Deutschland
| | - A Kunst
- Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - M Richter
- Martin- Luther- Universität Halle- Wittenberg, Institut für Medizinische Soziologie, Halle (Saale), Deutschland
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Moor I, Hoffmann L, Mlinarić M, Richter M. Die Rolle sozialer Netzwerke für gesundheitliche Ungleichheiten im jugendlichen Tabakkonsum. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667887] [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]
Affiliation(s)
- I Moor
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Medizinische Fakultät, Halle (Saale), Deutschland
| | - L Hoffmann
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Medizinische Fakultät, Halle (Saale), Deutschland
| | - M Mlinarić
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Medizinische Fakultät, Halle (Saale), Deutschland
| | - M Richter
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Medizinische Fakultät, Halle (Saale), Deutschland
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Buchenauer L, Kohler E, Mlinarić M, Hoffmann L, Richter M. Die „zwei Realitäten“ der Implementierung und Wirksamkeit von schulischer Tabakkontrolle – eine vergleichende Mixed Methods-Studie aus Schüler- und Lehrersicht. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667879] [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]
Affiliation(s)
- L Buchenauer
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Halle (Saale), Deutschland
| | - E Kohler
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Halle (Saale), Deutschland
| | - M Mlinarić
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Halle (Saale), Deutschland
| | - L Hoffmann
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Halle (Saale), Deutschland
| | - M Richter
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Halle (Saale), Deutschland
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Mlinarić M, Günther S, Moor I, Heilmann K, Hoffmann L, Richter M. Was ist „De-Normalisierung des Rauchens“? Befunde und Trends zu horizontalen und vertikalen Ungleichheiten im Jugendalter. Psychother Psych Med 2018. [DOI: 10.1055/s-0038-1667894] [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] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M Mlinarić
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Medizinische Fakultät, Halle (Saale), Deutschland
| | - S Günther
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Medizinische Fakultät, Halle (Saale), Deutschland
| | - I Moor
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Medizinische Fakultät, Halle (Saale), Deutschland
| | - K Heilmann
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Medizinische Fakultät, Halle (Saale), Deutschland
| | - L Hoffmann
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Medizinische Fakultät, Halle (Saale), Deutschland
| | - M Richter
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Soziologie, Medizinische Fakultät, Halle (Saale), Deutschland
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Hoffmann L, Mlinarić M, Buchenauer L, Kunst A, Richter M. Enhancing smoke-free environments at the local level: An empirically grounded type construction in 7 European cities. Tob Prev Cessat 2018. [DOI: 10.18332/tpc/91096] [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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Kandi M, Hoffmann L, Sloth Moeller D, Schmidt HH, Knap MM, Khalil AA. Local failure after radical radiotherapy of non-small cell lung cancer in relation to the planning FDG-PET/CT. Acta Oncol 2018; 57:813-819. [PMID: 29205088 DOI: 10.1080/0284186x.2017.1409436] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Local recurrence (rec) in lung cancer is associated with poor survival. This study examined whether the pattern of failure is associated with the most PET avid volume in the planning-FDG-PET/CT scan (p-PET/CT). METHODS 162 consecutive inoperable NSCLC patients (pts) receiving radiotherapy between January 2012 and April 2014 were reviewed. Radiotherapy was delivered in 2 Gy/fraction (5f/week) to a total dose of 60-66 Gy. Pts were followed with CT scans every third month. Patients with local rec as first event were analyzed. For the primary tumor (T) the overlap-fraction (OF) between 50% of SUVpeak on p-PET/CT and the volume of T-rec was calculated: OF = (SUVp50∩T-rec)/min(SUVp50, T-rec). Similarly for the GTV on the p-CT: OF = (GTV∩T-rec)/min(GTV, T-rec). OF was based on a rigid registration between p-PET/CT and rec-CT with PET guided delineation of T- rec. For lymph nodes (LN), the correlation between the location of treated-LN and the location of recurrence-LN was evaluated. RESULTS 67 patients developed local rec. 51 pts had rec in T-site, 45 pts in LN-site. Due to anatomical changes, reliable registration between p-CT and rec-CT was only obtained in 26 pts with T-rec. The median OFSUVp50 was 52, 8% [range 26; 100%] and the median OFGTV was 80.5% [19.7; 100%]. Eleven pts had higher OFSUVp50 than OFGTV. LN-rec predominantly occurred in the station 2R (32%), 4R (46%), 7 (46%) and right hilum (36%). Pts with malignant LNs in station 4R or 7 on p-CT had a high risk of rec in these stations; 4R (55%) and 7 (83%). CONCLUSIONS This study indicates that the most PET active volume on p-PET-CT is a driver for rec at T-site. LN-recurrences predominantly appear in station 2R, 4R, 7 and right hilum. Additional confirmatory studies regarding lymph node mapping and selective lymph node irradiation is needed.
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Affiliation(s)
- M. Kandi
- Department of Oncology, Aarhus University Hospital, Aarhus C, Denmark
| | - L. Hoffmann
- Department of Medical Physics, Aarhus University Hospital, Aarhus C, Denmark
| | - D. Sloth Moeller
- Department of Medical Physics, Aarhus University Hospital, Aarhus C, Denmark
| | - H. H. Schmidt
- Department of Oncology, Aarhus University Hospital, Aarhus C, Denmark
| | - M. M. Knap
- Department of Oncology, Aarhus University Hospital, Aarhus C, Denmark
| | - A. A. Khalil
- Department of Oncology, Aarhus University Hospital, Aarhus C, Denmark
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Elstrøm U, Alber M, Söhn M, Hoffmann L. EP-1832: Validation of Acuros XB dose calculation algorithm with Monte Carlo for clinical treatment plans. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32141-8] [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: 11/28/2022]
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Moeller D, Elstrøm U, Assenholt M, Hoffmann L. SP-0214: Clinical implementation of adaptive radiotherapy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30524-3] [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: 10/14/2022]
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Damkjær S, Hoffmann L, Møller D, Petersen J, Josipovic M, Persson G, Munck af Rosenschöld P, Poulsen P. EP-1812: Proton pencil beam scanning with motion emulated as spot shifts: dose reconstruction for lung cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32121-2] [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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Schytte T, Nielsen T, Moeller D, Hoffmann L, Khalil A, Knap M, Lund M, Nyhus C, Hansen T, Ottosson W, Borissova S, Appelt A, Brimk C, Hansen O. PO-0754: Safe inhomogeneus RT dose escalation in locally advanced NSCLC, -interim results from NARLAL2. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31064-8] [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: 11/29/2022]
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Hoffmann L, Bertholet J, Nordsmark M, Kruhlikava I, Helbo B, Schmidt M, Poulsen P. PO-0934: Detailed mapping of time-resolved 3D intra- and inter-fractional oesophageal tumour motion. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31244-1] [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: 10/14/2022]
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Moeller D, Nordsmark M, Nyeng T, Alber M, Hoffmann L. PO-0958: Anatomical changes in oesophageal cancer patients: Posterior beam IMPT is more robust than IMRT. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31268-4] [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: 10/14/2022]
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