1
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Dietz A, Wiegand S, Bläker H, Budach W. [Therapy of tumor recurrences or secondary carcinomas in pretreated area is not compatible with the primary therapy in non-previously treated tissue - an overview]. Laryngorhinootologie 2023; 102:908-915. [PMID: 37696291 DOI: 10.1055/a-2161-2807] [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: 09/13/2023]
Abstract
There are different initial situations in the treatment of local or locoregional recurrences, secondary carcinomas or residual squamous cell carcinomas of the head and neck region after primary therapy. The majority of patients with locoregional recurrences have had prior treatment consisting of surgery and/or postoperative radiotherapy or radiochemotherapy or primary radiotherapy or radiochemotherapy. In any case, it is a matter of new tumor growth in a previously treated area, which must be taken into account for the therapy decision. The biological backgrounds are diverse and are described in more detail and clinically classified in the present work.
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Affiliation(s)
| | - S Wiegand
- Hals-Nasen-Ohren-Universitätsklinik, Leipzig
| | - H Bläker
- Institut für Pathologie, Universität Leipzig
| | - W Budach
- Klinik für Strahlentherapie und Radioonkologie, Universität Düsseldorf
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2
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Eberhardt W, Poettgen C, Gauler T, Schulte C, Friedel G, Kopp HG, Fischer B, Schmidberger H, Kimmich M, Budach W, Cordes S, Metzenmacher M, de Los Rios RH, Spengler W, De Ruysscher D, Belka C, Welter S, Brintrup DL, Guberina M, Oezkan F, Darwiche K, Schuler M, Jöckel KH, Aigner C, Stamatis G, Stuschke M. MA06.08 Long-term Survival and Competing Risks of Death in the ESPATUE Randomized Phase-III Trial in Stage III NSCLC. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.110] [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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3
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Dapper H, Belka C, Bock F, Budach V, Budach W, Christiansen H, Debus J, Distel L, Dunst J, Eckert F, Eich H, Eicheler W, Engenhart-Cabillic R, Fietkau R, Fleischmann DF, Frerker B, Giordano FA, Grosu AL, Herfarth K, Hildebrandt G, Kaul D, Kölbl O, Krause M, Krug D, Martin D, Matuschek C, Medenwald D, Nicolay NH, Niewald M, Oertel M, Petersen C, Pohl F, Raabe A, Rödel C, Rübe C, Schmalz C, Schmeel LC, Steinmann D, Stüben G, Thamm R, Vordermark D, Vorwerk H, Wiegel T, Zips D, Combs SE. Integration of radiation oncology teaching in medical studies by German medical faculties due to the new licensing regulations : An overview and recommendations of the consortium academic radiation oncology of the German Society for Radiation Oncology (DEGRO). Strahlenther Onkol 2021; 198:1-11. [PMID: 34786605 PMCID: PMC8594460 DOI: 10.1007/s00066-021-01861-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 09/01/2021] [Accepted: 09/19/2021] [Indexed: 11/30/2022]
Abstract
The new Medical Licensing Regulations 2025 (Ärztliche Approbationsordnung, ÄApprO) will soon be passed by the Federal Council (Bundesrat) and will be implemented step by step by the individual faculties in the coming months. The further development of medical studies essentially involves an orientation from fact-based to competence-based learning and focuses on practical, longitudinal and interdisciplinary training. Radiation oncology and radiation therapy are important components of therapeutic oncology and are of great importance for public health, both clinically and epidemiologically, and therefore should be given appropriate attention in medical education. This report is based on a recent survey on the current state of radiation therapy teaching at university hospitals in Germany as well as the contents of the National Competence Based Learning Objectives Catalogue for Medicine 2.0 (Nationaler Kompetenzbasierter Lernzielkatalog Medizin 2.0, NKLM) and the closely related Subject Catalogue (Gegenstandskatalog, GK) of the Institute for Medical and Pharmaceutical Examination Questions (Institut für Medizinische und Pharmazeutische Prüfungsfragen, IMPP). The current recommendations of the German Society for Radiation Oncology (Deutsche Gesellschaft für Radioonkologie, DEGRO) regarding topics, scope and rationale for the establishment of radiation oncology teaching at the respective faculties are also included.
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Affiliation(s)
- H Dapper
- Department of Radiation Oncology, Technical University of Munich, Munich, Germany. .,German Cancer Consortium (DKTK) Partner Site (DKTK), Munich, Germany.
| | - C Belka
- Department of Radiation Oncology, LMU University Hospital, Munich, Germany.,German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - F Bock
- Department of Radiation Oncology, Rostock University Medical Center, Rostock, Germany
| | - V Budach
- Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiation Oncology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - W Budach
- Department of Radiation Oncology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
| | - H Christiansen
- Department of Radiation Oncology, Hannover Medical School (MHH), Hannover, Germany
| | - J Debus
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Heidelberg, Germany
| | - L Distel
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen, Germany
| | - J Dunst
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - F Eckert
- Department of Radiation Oncology, University of Tübingen, Tübingen, Germany.,German Cancer Consortium (DKTK) Partner Site (DKTK), Tübingen, Germany
| | - H Eich
- Department of Radiation Oncology, University of Münster, Münster, Germany
| | - W Eicheler
- OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - R Engenhart-Cabillic
- Department of Radiotherapy and Radiation Oncology, University of Marburg, Marburg, Germany
| | - R Fietkau
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen, Germany
| | - D F Fleischmann
- Department of Radiation Oncology, LMU University Hospital, Munich, Germany.,German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - B Frerker
- Department of Radiation Oncology, Rostock University Medical Center, Rostock, Germany
| | - F A Giordano
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - A L Grosu
- Department of Radiation Oncology, University Medical Center Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK) Partner Site (DKTK), Freiburg, Germany
| | - K Herfarth
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Heidelberg, Germany
| | - G Hildebrandt
- Department of Radiation Oncology, Rostock University Medical Center, Rostock, Germany
| | - D Kaul
- Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiation Oncology, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Partner Site Berlin, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - O Kölbl
- Department of Radiotherapy, University of Regensburg, Regensburg, Germany
| | - M Krause
- Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden and Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.,Partner Site Dresden, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), Heidelberg, Germany.,Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.,Heidelberg and German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Dresden, Germany
| | - D Krug
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - D Martin
- Department of Radiotherapy and Oncology, University Hospital, Goethe University, Frankfurt, Germany.,German Cancer Consortium (DKTK) Partner Site (DKTK), Frankfurt, Germany
| | - C Matuschek
- Department of Radiation Oncology, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
| | - D Medenwald
- Deptartment of Radiation Oncology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - N H Nicolay
- Department of Radiation Oncology, University Medical Center Freiburg, Freiburg, Germany.,German Cancer Consortium (DKTK) Partner Site (DKTK), Freiburg, Germany
| | - M Niewald
- Department of Radiotherapy and Radiooncology, Saarland University Medical Center, Homburg, Germany
| | - M Oertel
- Department of Radiation Oncology, University of Münster, Münster, Germany
| | - C Petersen
- Department of Radiotherapy and Radio-Oncology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - F Pohl
- Department of Radiotherapy, University of Regensburg, Regensburg, Germany
| | - A Raabe
- Department of Radiotherapy and Radio-Oncology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - C Rödel
- Department of Radiotherapy and Oncology, University Hospital, Goethe University, Frankfurt, Germany.,German Cancer Consortium (DKTK) Partner Site (DKTK), Frankfurt, Germany
| | - C Rübe
- Department of Radiotherapy and Radiooncology, Saarland University Medical Center, Homburg, Germany
| | - C Schmalz
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - L C Schmeel
- Department of Radiation Oncology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - D Steinmann
- Department of Radiation Oncology, Hannover Medical School (MHH), Hannover, Germany
| | - G Stüben
- Department of Radiation Oncology, University of Augsburg, Augsburg, Germany
| | - R Thamm
- Department of Radiation Oncology and Radiotherapy, University Hospital Ulm, Ulm, Germany
| | - D Vordermark
- Deptartment of Radiation Oncology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - H Vorwerk
- Department of Radiotherapy and Radiation Oncology, University of Marburg, Marburg, Germany
| | - T Wiegel
- Department of Radiation Oncology and Radiotherapy, University Hospital Ulm, Ulm, Germany
| | - D Zips
- Department of Radiation Oncology, University of Tübingen, Tübingen, Germany.,German Cancer Consortium (DKTK) Partner Site (DKTK), Tübingen, Germany
| | - S E Combs
- Department of Radiation Oncology, Technical University of Munich, Munich, Germany.,Institute of Radiation Medicine, Department of Radiation Sciences, Helmholtz Zentrum München, Munich, Germany.,German Cancer Consortium (DKTK) Partner Site (DKTK), Munich, Germany
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4
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Haussmann J, Budach W, Corradini S, Tamaskovics B, Boelke E, Djiepmo-Njanang F, Kammers K, Matuschek C. PH-0596: Whole breast irradiation in comparison to endocrine therapy in early stage breast cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00618-6] [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: 10/22/2022]
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5
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Unger K, Fleischmann D, Ruf V, Felsberg J, Piehlmaier D, Samaga D, Heß J, Mittelbronn M, Lauber K, Budach W, Sabel M, Rödel C, Reifenberger G, Herms J, Tonn J, Zitzelsberger H, Belka C, Niyazi M. OC-0322: 4-miRNA signature and MGMT promoter methylation improve risk stratification in glioblastoma. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00346-7] [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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6
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Matuschek C, Budach W, Bojar H, Fehm T, Nestle-Krämling C, Corradini S, Fastner G, Seidel C, Krug D, Tamaskovics B, Bölke E, Kühn T, Haussmann J. Präoperative Strahlentherapie (PRT) und Systemtherapie beim Mammakarzinom – welche Faktoren beeinflussen das Gesamtüberleben (OS)? Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- C Matuschek
- Universitätsklinikum Düsseldorf, Klinik für Strahlentherapie und Radioonkologie
| | - W Budach
- Universitätsklinikum Düsseldorf, Klinik für Strahlentherapie und Radioonkologie
| | | | - T Fehm
- Universitätsfrauenklinik Düsseldorf, Frauenklinik
| | | | - S Corradini
- Ludwig-Maximilians-Universität München, Klinik für Strahlentherapie und Radioonkologie
| | - G Fastner
- Universitätsklinik Salzburg, Klinik für Strahlentherapie und Radioonkologie
| | - C Seidel
- Universitätsklinik Leipzig, Klinik für Strahlentherapie und Radioonkologie
| | - D Krug
- Universiätsklinik Schleswig-Holstein, Campus Kiel, Klinik für Strahlentherapie und Radioonkologie
| | - B Tamaskovics
- Universitätsklinikum Düsseldorf, Klinik für Strahlentherapie und Radioonkologie
| | - E Bölke
- Universitätsklinikum Düsseldorf, Klinik für Strahlentherapie und Radioonkologie
| | - T Kühn
- Klinikum Esslingen, Frauenklinik
| | - J Haussmann
- Universitätsklinikum Düsseldorf, Klinik für Strahlentherapie und Radioonkologie
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7
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Haussmann J, Tamaskovics B, Budach W, Bölke E, Corradini S, Djiepmo-Njanang FJ, Matuschek C. Teil- und Ganzbrustbestrahlung beim Mammakarzinom im Frühstadium. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714522] [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] Open
Affiliation(s)
- J Haussmann
- Heinrich Heine Universität, Klinik für Strahlentherapie und Radiologische Onkologie
| | - B Tamaskovics
- Heinrich Heine Universität, Klinik für Strahlentherapie und Radiologische Onkologie
| | - W Budach
- Heinrich Heine Universität, Klinik für Strahlentherapie und Radiologische Onkologie
| | - E Bölke
- Universitätsklinikum Düsseldorf, Klinik für Strahlentherapie und radiologische Onkologie
| | | | - F-J Djiepmo-Njanang
- Heinrich Heine Universität, Klinik für Strahlentherapie und Radiologische Onkologie
| | - C Matuschek
- Universitätsklinikum Düsseldorf, Klinik für Strahlentherapie und radiologische Onkologie
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8
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Strnad V, Krug D, Sedlmayer F, Piroth MD, Budach W, Baumann R, Feyer P, Duma MN, Haase W, Harms W, Hehr T, Fietkau R, Dunst J, Sauer R. DEGRO practical guideline for partial-breast irradiation. Strahlenther Onkol 2020; 196:749-763. [PMID: 32350554 PMCID: PMC7449998 DOI: 10.1007/s00066-020-01613-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 03/19/2020] [Indexed: 12/24/2022]
Abstract
Purpose This consensus statement from the Breast Cancer Working Group of the German Society for Radiation Oncology (DEGRO) aims to define practical guidelines for accelerated partial-breast irradiation (APBI). Methods Recent recommendations for relevant aspects of APBI were summarized and a panel of experts reviewed all the relevant literature. Panel members of the DEGRO experts participated in a series of conferences, supplemented their clinical experience, performed a literature review, and formulated recommendations for implementing APBI in clinical routine, focusing on patient selection, target definition, and treatment technique. Results Appropriate patient selection, target definition for different APBI techniques, and basic rules for appropriate APBI techniques for clinical routine outside of clinical trials are described. Detailed recommendations for APBI in daily practice, including dose constraints, are given. Conclusion Guidelines are mandatory to assure optimal results of APBI using different techniques.
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Affiliation(s)
- V Strnad
- University Hospital Erlangen, Erlangen, Germany.
| | - D Krug
- University Hospital Schleswig-Holstein, Kiel, Germany
| | - F Sedlmayer
- Paracelsus Medical University Hospital Salzburg, Salzburg, Austria
| | - M D Piroth
- Helios University Hospital Wuppertal, Witten/Herdecke University, Wuppertal, Germany
| | - W Budach
- Heinrich-Heine-University Hospital Düsseldorf, Düsseldorf, Germany
| | - R Baumann
- St. Marien-Krankenhaus Siegen, Siegen, Germany
| | - P Feyer
- Vivantes Hospital Neukoelln, Berlin, Germany
| | - M N Duma
- University Hospital, Jena, Germany
| | - W Haase
- St.-Vincentius-Hospital Karlsruhe, Karlsruhe, Germany
| | - W Harms
- St. Claraspital Basel, Basel, Switzerland
| | - T Hehr
- Marienhospital Stuttgart, Stuttgart, Germany
| | - R Fietkau
- University Hospital Erlangen, Erlangen, Germany
| | - J Dunst
- University Hospital Schleswig-Holstein, Kiel, Germany
| | - R Sauer
- University Hospital Erlangen, Erlangen, Germany
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9
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Ruhstaller T, Thuss-Patience P, Hayoz S, Schacher S, Knorrenschild JR, Schnider A, Plasswilm L, Budach W, Eisterer W, Hawle H, Mariette C, Hess V, Mingrone W, Montemurro M, Girschikofsky M, Schmidt SC, Bitzer M, Bedenne L, Brauchli P, Stahl M. Neoadjuvant chemotherapy followed by chemoradiation and surgery with and without cetuximab in patients with resectable esophageal cancer: a randomized, open-label, phase III trial (SAKK 75/08). Ann Oncol 2019; 29:1386-1393. [PMID: 29635438 DOI: 10.1093/annonc/mdy105] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background This open-label, phase III trial compared chemoradiation followed by surgery with or without neoadjuvant and adjuvant cetuximab in patients with resectable esophageal carcinoma. Patients and methods Patients were randomly assigned (1 : 1) to two cycles of chemotherapy (docetaxel 75 mg/m2, cisplatin 75 mg/m2) followed by chemoradiation (45 Gy, docetaxel 20 mg/m2 and cisplatin 25 mg/m2, weekly for 5 weeks) and surgery, with or without neoadjuvant cetuximab 250 mg/m2 weekly and adjuvant cetuximab 500 mg/m2 fortnightly for 3 months. The primary end point was progression-free survival (PFS). Results In total, 300 patients (median age, 61 years; 88% male; 63% adenocarcinoma; 85% cT3/4a, 90% cN+) were assigned to cetuximab (n = 149) or control (n = 151). The R0-resection rate was 95% for cetuximab versus 97% for control. Postoperative treatment-related mortality was 6% in both arms. Median PFS was 2.9 years [95% confidence interval (CI), 2.0 to not reached] with cetuximab and 2.0 years (95% CI, 1.5-2.8) with control [hazard ratio (HR), 0.79; 95% CI, 0.58-1.07; P = 0.13]. Median overall survival (OS) time was 5.1 years (95% CI, 3.7 to not reached) versus 3.0 years (95% CI, 2.2-4.2) for cetuximab and control, respectively (HR, 0.73; 95% CI, 0.52-1.01; P = 0.055). Time to loco-regional failure after R0-resection was significantly longer for cetuximab (HR 0.53; 95% CI, 0.31-0.90; P = 0.017); time to distant failure did not differ between arms (HR, 1.01; 95% CI, 0.64-1.59, P = 0.97). Cetuximab did not increase adverse events in neoadjuvant or postoperative settings. Conclusion Adding cetuximab to multimodal therapy significantly improved loco-regional control, and led to clinically relevant, but not-significant improvements in PFS and OS in resectable esophageal carcinoma. Clinical trial information NCT01107639.
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Affiliation(s)
- T Ruhstaller
- Cantonal Hospital of St. Gallen, St. Gallen, Switzerland.
| | | | - S Hayoz
- SAKK Coordinating Center, Berne, Switzerland
| | - S Schacher
- Cantonal Hospital of Winterthur, Winterthur, Switzerland
| | | | - A Schnider
- City Hospital Triemli, Zürich, Switzerland
| | - L Plasswilm
- Cantonal Hospital of St. Gallen, St. Gallen, Switzerland; University of Berne, Berne, Switzerland
| | - W Budach
- University Hospital Düsseldorf, Düsseldorf, Germany
| | - W Eisterer
- Medical University of Innsbruck, Innsbruck, Austria
| | - H Hawle
- SAKK Coordinating Center, Berne, Switzerland
| | - C Mariette
- Hôpital Universitaire C. Huriez, Lille, France
| | - V Hess
- University Hospital of Basel, Basel, Switzerland
| | - W Mingrone
- Cantonal Hospital of Olten, Olten, Switzerland
| | - M Montemurro
- University Hospital of Lausanne, Lausanne, Switzerland
| | | | - S C Schmidt
- Charité - University Medicine, Berlin, Germany
| | - M Bitzer
- University Hospital of Tübingen, Tübingen, Germany
| | - L Bedenne
- Hospital Center Regional University of Dijon, Dijon, France
| | - P Brauchli
- SAKK Coordinating Center, Berne, Switzerland
| | - M Stahl
- Kliniken Essen-Mitte, Essen, Germany
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10
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Hecht M, Gostian AO, Eckstein M, Rutzner S, von der Grün J, Illmer T, Hautmann M, Brunner T, Laban S, Klautke G, Tamaskovics B, Frey B, Hartmann A, Rödel C, Budach W, Gaipl U, Iro H, Fietkau R. Single cycle induction treatment with cisplatin/docetaxel plus durvalumab/tremelimumab in stage III-IVB head and neck squamous cell cancer (CheckRad-CD8 trial). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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11
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Matuschek C, Tamaskovics B, Budach W, Haussmann J, Boelke E, Djiepmo F, Fehm T, Ruckhaeberle E, Fleisch M, Roth S. EP-1281 New aspects regarding the treatment of multicentric compared to unifocal breast cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31701-3] [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: 11/27/2022]
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12
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Fastner G, Reitsamer R, Hitzl W, Murawa D, Milecki P, Reiland J, Ciabattoni A, Budach W, Brimmer R, Sedlmayer F. Hypofractionated whole breast irradiation and IOERT in breast cancer: toxicity and cosmetic outcome. Breast 2019. [DOI: 10.1016/s0960-9776(19)30287-5] [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: 10/27/2022] Open
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13
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Matuschek C, Boelke E, Kammers K, Haussmann J, Joeres F, Budach W. Adjuvant Radiation Therapy for High Risk Head and Neck Cancer Patients: Is Accelerated Better Than Conventionally Fractionated Radiation Therapy? Results of a Meta-analysis. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1454] [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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14
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Boelke E, Matuschek C, Goessler B, Budach W. Incidence and Clinical Outcome of Head and Neck Cancer Patients in Dusseldorf With Human Papillomavirus Infection. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1598] [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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15
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Boelke E, Matuschek C, Budach W, Hayman A. New Approaches Regarding the Radiation Therapy of Thalamic Gliomas. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.842] [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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16
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Ghorbanpour Besheli M, Matuscheck C, Budach W, Simiantonakis I. EP-1570: Determination of stopping power ratios and output factors of intraoperative electron beams. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32820-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Boelke E, Budach W, Matuschek C, Hayman A. EP-1123: New aspects regarding the radiation of thalamic gliomas. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32373-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Matuschek C, Boelke E, Halfmann K, Ghorbanpour M, Hoffmann J, Fehm T, Budach W, Mohrmann S. EP-1186: Late side effects and cosmetic outcome after intraoperative electron radiotherapy in breast cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32436-7] [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: 10/21/2022]
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Harms W, Budach W, Dunst J, Feyer P, Fietkau R, Haase W, Krug D, Piroth MD, Sautter-Bihl ML, Sedlmayer F, Souchon R, Wenz F, Sauer R. DEGRO practical guidelines for radiotherapy of breast cancer VI: therapy of locoregional breast cancer recurrences. Strahlenther Onkol 2016; 192:199-208. [PMID: 26931319 PMCID: PMC4833793 DOI: 10.1007/s00066-015-0939-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 12/22/2015] [Indexed: 02/07/2023]
Abstract
Objective To update the practical guidelines for radiotherapy of patients with locoregional breast cancer recurrences based on the current German interdisciplinary S3 guidelines 2012. Methods A comprehensive survey of the literature using the search phrases “locoregional breast cancer recurrence”, “chest wall recurrence”, “local recurrence”, “regional recurrence”, and “breast cancer” was performed, using the limits “clinical trials”, “randomized trials”, “meta-analysis”, “systematic review”, and “guidelines”. Conclusions Patients with isolated in-breast or regional breast cancer recurrences should be treated with curative intent. Mastectomy is the standard of care for patients with ipsilateral breast tumor recurrence. In a subset of patients, a second breast conservation followed by partial breast irradiation (PBI) is an appropriate alternative to mastectomy. If a second breast conservation is performed, additional irradiation should be mandatory. The largest reirradiation experience base exists for multicatheter brachytherapy; however, prospective clinical trials are needed to clearly define selection criteria, long-term local control, and toxicity. Following primary mastectomy, patients with resectable locoregional breast cancer recurrences should receive multimodality therapy including systemic therapy, surgery, and radiation +/− hyperthermia. This approach results in high local control rates and long-term survival is achieved in a subset of patients. In radiation-naive patients with unresectable locoregional recurrences, radiation therapy is mandatory. In previously irradiated patients with a high risk of a second local recurrence after surgical resection or in patients with unresectable recurrences, reirradiation should be strongly considered. Indication and dose concepts depend on the time interval to first radiotherapy, presence of late radiation effects, and concurrent or sequential systemic treatment. Combination with hyperthermia can further improve tumor control. In patients with isolated axillary or supraclavicular recurrence, durable disease control is best achieved with multimodality therapy including surgery and radiotherapy. Radiation therapy significantly improves local control and should be applied whenever feasible.
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Affiliation(s)
- Wolfgang Harms
- Abteilung für Radioonkologie, St. Claraspital, Kleinriehenstrasse 30, 4016, Basel, Switzerland.
| | - W Budach
- Heinrich-Heine-University, Duesseldorf, Germany
| | - J Dunst
- University Hospital Schleswig-Holstein, Kiel, Germany
| | - P Feyer
- Vivantes Hospital Neukoelln, Berlin, Germany
| | - R Fietkau
- University Hospital Erlangen, Erlangen, Germany
| | - W Haase
- Formerly St.-Vincentius-Hospital, Karlsruhe, Germany
| | - D Krug
- University Hospital Heidelberg, Heidelberg, Germany
| | - M D Piroth
- HELIOS-Hospital Wuppertal, Witten/Herdecke University, Wuppertal, Germany
| | | | - F Sedlmayer
- Paracelsus Medical University Hospital, Salzburg, Austria
| | - R Souchon
- Formerly University Hospital Tuebingen, Tuebingen, Germany
| | - F Wenz
- University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - R Sauer
- University Hospital Erlangen, Erlangen, Germany
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Matuschek C, Boelke E, Budach W, Audretsch W, Wollandt S, Speer V, Nestle-Krämling C. Abstract P3-12-09: Neoadjuvant radiochemotherapy in breast cancer- A safe and effect method for patients. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-12-09] [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: 11/16/2022]
Abstract
Abstract
BACKGROUND:
Neoaduvant radiochemotherapy (NRT-CHT) is the standard of care for many solid tumors. It could be also an alternative option for treating patients with locally advanced non inflammatory breast cancer (LABC). Surgeons are afraid of wound healing problems and fear bad cosmetic results. The purpose of this investigation was to find out if there are any acute or late side effects in breast conserving and mastectomy patients after NRT-CHX.
PATIENTS AND METHODS:
From 1991 to 1998 a total of 315 LABC patients (cT1-cT4/cN0-N1) were treated with NRT-CHX. Preoperative radiotherapy (RT) consisted of external beam radiation therapy (EBRT) of 50 Gy (5 × 2 Gy/week) to the breast and the supra-/infraclavicular lymph nodes combined with a consecutive electron boost in 214 cases or - in case of breast conservation - a 10-Gy interstitial boost with (192)Ir afterloading before EBRT. Chemotherapy was given prior to RT in 192 patients, and concomitantly in 113; 10 patients received no chemotherapy. Also we investigated the acute side effects in 10 patients with NRT-CHX who were treated with this method from 2012-2015.
The cosmetic outcome was assessed by patient questionnaire, panel evaluation, and breast retraction assessment (BRA). Quality-of-life was investigated by EORTC QLQ-C30 and BR23 and acute and late radiation side effects by LENT/SOMA scale
RESULTS:
The long term results of 64 patients after breast conserving surgery and 152 patients after mastectomy were available. Most patients rated their overall cosmetics as excellent or good (94% breast conserving, 55.8% mastectomy). Patient and panel ratings on all cosmetic outcomes were similar between the two groups. After a follow up of 14-23 years we did not detect any grade III or IV fibrosis in any of our groups. The median BRA score after breast conserving surgery was 2.9 and the over-all quality of life (QLQ-C30) was rated "excellent" or good in 82%. Furthermore we did not detect any grade 3 or 4 acute side effects in our 10 patients who were recently treated with NRT-CHX.
CONCLUSION:
NRT-CHX is safe method and it is not associated with severe grade 3 or 4 acute or late side effects.
Citation Format: Matuschek C, Boelke E, Budach W, Audretsch W, Wollandt S, Speer V, Nestle-Krämling C. Neoadjuvant radiochemotherapy in breast cancer- A safe and effect method for patients. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-12-09.
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Affiliation(s)
- C Matuschek
- Heinrich Heine University, Dusseldorf, NRW, Germany; Sana Hospital Dusseldorf, Dusseldorf, NRW, Germany; Marienhospital, Dusseldorf, NRW, Germany
| | - E Boelke
- Heinrich Heine University, Dusseldorf, NRW, Germany; Sana Hospital Dusseldorf, Dusseldorf, NRW, Germany; Marienhospital, Dusseldorf, NRW, Germany
| | - W Budach
- Heinrich Heine University, Dusseldorf, NRW, Germany; Sana Hospital Dusseldorf, Dusseldorf, NRW, Germany; Marienhospital, Dusseldorf, NRW, Germany
| | - W Audretsch
- Heinrich Heine University, Dusseldorf, NRW, Germany; Sana Hospital Dusseldorf, Dusseldorf, NRW, Germany; Marienhospital, Dusseldorf, NRW, Germany
| | - S Wollandt
- Heinrich Heine University, Dusseldorf, NRW, Germany; Sana Hospital Dusseldorf, Dusseldorf, NRW, Germany; Marienhospital, Dusseldorf, NRW, Germany
| | - V Speer
- Heinrich Heine University, Dusseldorf, NRW, Germany; Sana Hospital Dusseldorf, Dusseldorf, NRW, Germany; Marienhospital, Dusseldorf, NRW, Germany
| | - C Nestle-Krämling
- Heinrich Heine University, Dusseldorf, NRW, Germany; Sana Hospital Dusseldorf, Dusseldorf, NRW, Germany; Marienhospital, Dusseldorf, NRW, Germany
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Matuschek C, Boelke E, Kammers K, Gripp S, Budach W. Is Induction Chemotherapy With TPF and Radiation Chemotherapy in Advanced Head and Neck Cancer Too Toxic: A Meta-Analysis of Randomized Trails. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1741] [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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Boelke E, Matuschek C, Budach W, Speer V, Wollandt S, Audretsch W, Gerber A, Kraemling CN. Cosmetic Outcome Assessment After Neoadjuvant Radiochemotherapy in Breast Cancer Patients. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.545] [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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Djiepmo Njanang F, Matuschek C, Djiepmo F, Boelke E, Budach W. Influence de la dose individuelle et totale, du temps de traitement, de la taille du champ de traitement, et paramètres cliniques pendant l’irradiation de maladies dégénératives à l’exemple de l’épine calcanéenne. Cancer Radiother 2015. [DOI: 10.1016/j.canrad.2015.07.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Matuschek C, Boelke E, Budach W, Speer V, Bojar H, Audretsch W, Nestle K. NEW ASPECTS REGARDING NEOADJUVANT RADIOCHEMOTHERAPY IN LOCALLY ADVANCED NONINFLAMMATORY BREAST CANCER AND PREDICTIVE FACTORS FOR A PATHOLOGIC COMPLETE REMISSION: IGCS-0016 Breast Cancer. Int J Gynecol Cancer 2015. [DOI: 10.1136/00009577-201505001-00001] [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: 11/04/2022] Open
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Boelke E, Budach W, Speer V, Wollandt S, Gerber PA, Audretsch W, Krämling NC, Matuschek C. COSMETIC OUTCOME ASSESSMENT AFTER NEOADJUVANT RADIOCHEMOTHERAPY IN BREAST CANCER PATIENTS: IGCS-0036 Breast Cancer. Int J Gynecol Cancer 2015. [DOI: 10.1136/00009577-201505001-00004] [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: 11/03/2022] Open
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Fastner G, Reitsamer R, Murawa D, Milecki P, Hager E, Ciabattoni A, Brimmer R, Reiland J, Budach W, Sedlmayer F. OC-0474: Hypofractionated WBI plus IOERT-boost in early stage breast cancer (HIOB): Updated results of a prospective trial. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40469-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Matuschek C, Boelke E, Budach W, Gerber A, Speer V, Audretsch W, Wollandt S, Nestle Krämling C. PO-0687: Cosmetic outcome assessment after neoadjuvant radiochemotherapy in breast cancer patients. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40679-6] [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: 11/17/2022]
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Budach W. SP-0325: Participation to databases should not be made mandatory. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40323-8] [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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Sautter-Bihl ML, Sedlmayer F, Budach W, Dunst J, Feyer P, Fietkau R, Haase W, Harms W, Piroth MD, Souchon R, Wenz F, Sauer R. How nescience may obscure evidence. Strahlenther Onkol 2014; 190:861-3. [PMID: 25238991 DOI: 10.1007/s00066-014-0755-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- M-L Sautter-Bihl
- Klinik für Radioonkologie und Strahlentherapie, Städtisches Klinikum Karlsruhe gGmbH, 76133, Karlsruhe, Moltkestr. 90, Germany,
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Abstract
Despite major progress in clinical diagnostics and therapy, esophageal carcinoma represents a tumor entity with limited prognosis. In case of carcinoma restricted to mucosa endoscopic resection has developed into an important therapeutic method. Surgical resection represents the standard procedure for patients with locally limited (cT1/T2, N0) and advanced carcinoma (cT3, T4, Nx). In multimodal therapy neoadjuvant treatment concepts with chemotherapy or radiochemotherapy for patients with locally advanced tumors are well established. In case of metastatic disease palliative radio- and chemotherapy represent a treatment concept, however therapy efficiency is very limited. This review reflects the current status of multimodal therapy.
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Affiliation(s)
- D Graf
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Heinrich-Heine-Universität Düsseldorf
| | - D Vallböhmer
- Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Heinrich-Heine-Universität Düsseldorf
| | - W T Knoefel
- Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Heinrich-Heine-Universität Düsseldorf
| | - W Budach
- Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Heinrich-Heine-Universität Düsseldorf
| | - D Häussinger
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Heinrich-Heine-Universität Düsseldorf
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Boelke E, Matuschek C, Kammers K, Budach W. New Aspects Regarding the Adjuvant Radiation Therapy to the Internal Mammary and Medial Lymph Nodes in Breast Cancer: A Meta-analysis of Randomized Trials. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hagmeyer L, Kocher M, Schilcher B, Wassenberg D, Budach W, Priegnitz C, Randerath WJ. Anwendung von Färbungen und Goldmarkern bei konventioneller und elektromagnetischer Bronchoskopie (ENB): neue interdisziplinäre Ansätze bei unklaren pulmonalen Rundherden. Pneumologie 2014. [DOI: 10.1055/s-0034-1367818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sedlmayer F, Sautter-Bihl ML, Budach W, Dunst J, Fastner G, Feyer P, Fietkau R, Haase W, Harms W, Souchon R, Wenz F, Sauer R. DEGRO practical guidelines: radiotherapy of breast cancer I: radiotherapy following breast conserving therapy for invasive breast cancer. Strahlenther Onkol 2014; 189:825-33. [PMID: 24002382 PMCID: PMC3825416 DOI: 10.1007/s00066-013-0437-8] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background and purpose The aim of the present paper is to update the practical guidelines for postoperative adjuvant radiotherapy of breast cancer published in 2007 by the breast cancer expert panel of the German Society for Radiooncology (Deutsche Gesellschaft für Radioonkologie, DEGRO). The present recommendations are based on a revision of the German interdisciplinary S-3 guidelines published in July 2012. Methods A comprehensive survey of the literature concerning radiotherapy following breast conserving therapy (BCT) was performed using the search terms “breast cancer”, “radiotherapy”, and “breast conserving therapy”. Data from lately published meta-analyses, recent randomized trials, and guidelines of international breast cancer societies, yielding new aspects compared to 2007, provided the basis for defining recommendations according to the criteria of evidence-based medicine. In addition to the more general statements of the DKG (Deutsche Krebsgesellschaft), this paper addresses indications, target definition, dosage, and technique of radiotherapy of the breast after conservative surgery for invasive breast cancer. Results Among numerous reports on the effect of radiotherapy during BCT published since the last recommendations, the recent EBCTCG report builds the largest meta-analysis so far available. In a 15 year follow-up on 10,801 patients, whole breast irradiation (WBI) halves the average annual rate of disease recurrence (RR 0.52, 0.48–0.56) and reduces the annual breast cancer death rate by about one sixth (RR 0.82, 0.75–0.90), with a similar proportional, but different absolute benefit in prognostic subgroups (EBCTCG 2011). Furthermore, there is growing evidence that risk-adapted dose augmentation strategies to the tumor bed as well as the implementation of high precision RT techniques (e.g., intraoperative radiotherapy) contribute substantially to a further reduction of local relapse rates. A main focus of ongoing research lies in partial breast irradiation strategies as well as WBI hypofractionation schedules. The potential of both in replacing normofractionated WBI has not yet been finally clarified. Conclusion After breast conserving surgery, no subgroup even in low risk patients has yet been identified for whom radiotherapy can be safely omitted without compromising local control and, hence, cancer-specific survival. In most patients, this translates into an overall survival benefit.
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Affiliation(s)
- F Sedlmayer
- Department of Radiotherapy and Radiation Oncology, LKH Salzburg, Paracelsus Medical University Hospital, Muellner Haupstr. 48, Salzburg, Austria,
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Matuschek C, Kammers K, Boelke E, Budach W. OC-0149: Adjuvant radiotherapy of regional lymph nodes in breast cancer - a meta-analysis of randomized trials. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30254-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Matuschek C, Boelke E, Prisack HB, Budach W, Nestle-Krämling C, Gerber PA, Pagouras C, Bojar H. Abstract P6-05-02: Molecular genetic grading in breast cancer: Development and validation of a prognostic marker. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p6-05-02] [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: 11/16/2022]
Abstract
Abstract
Background: Histopathological grading is an important part for the characterization of breast cancer with regard to prognosis and treatment options. 30-60% of breast cancer patients have a grade 2 (G2) malignancy resulting in an intermediate prognosis and the challenge of finding individualized adequate treatment options. Moreover, the lack of objectivity of the grading system is criticized. With the genetic analysis of breast cancer, the deciphering of its genes and gene expression profiling using microarray technology is a new way of classifying breast cancer
Patients, Materials, and Methods. Tumor tissue from 229 breast cancer patients collected from January 2009 - June 2010 was examined. A histological grading of the tumors was determined and gene expression profiling was performed by microarray technology (Agilent Technologies). Gene expression data were reduced and a novel molecular grade index (MGI-9) was defined as a G1 versus G3 classifier by SAM (Significance Analysis of Microarray) and PAM (Prediction Analysis of Microarray). The validity of the newly defined MGI-9 as a prognostic factor was tested by applying it to three published data sets with external follow-up information for a total of 760 patients
Results: The significance analysis of gene expression profiles of 229 breast cancer patients using SAM showed more than 11,000 significantly differentially expressed genes according to the grading classes G1-2-3. The number of differentially expressed genes was reduced to 228 genes by SAM analysis using only the G1 vs. G3 cases (63 patients). PAM analysis resulted in a more reduced classifier of 44 molecular probes and we could show that a subset of 9 genes gave similar classification results and could reliably used in FFPE Material. The new MGI-9 index was tested in thee external data sets (GSE1456, GSE2034 and GSE3494) and could subdivide the histological G2 group in two molecular subgroups G2A and G2B with significant impact on survival in all test scenarios.
Conclusion: The results show that MGI 9-gene molecular grade index is more informative than the conventional histopathological grading system. In order to validate MGI-9 a prospective, randomized study with long-term follow-up for local recurrence rate and distant metastases is urgently needed.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-05-02.
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Affiliation(s)
- C Matuschek
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany
| | - E Boelke
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany
| | - HB Prisack
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany
| | - W Budach
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany
| | - C Nestle-Krämling
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany
| | - PA Gerber
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany
| | - C Pagouras
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany
| | - H Bojar
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany
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Matuschek C, Boelke E, Nestle-Krämling C, Speer V, Prisack H, Gerber PA, Bojar H, Audretsch W, Roth S, Budach W. Abstract P6-05-03: Evaluation of predictive markers for clinical outcome after neoadjuvant radiochemotherapy in breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p6-05-03] [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: 11/16/2022]
Abstract
Abstract
BACKGROUND:
Neoadjuvant radiochemotherapy (NRT-CHX) in locally advanced noninflammatory breast cancer (LABC) is an innovative method in treating patients. Proliferation markers make up the majority of genes included in RNA-based prognostic gene signatures applied for breast cancer patients. In this subgroup analysis long-term clinical outcome data and predictive factors were analyzed.
PATIENTS AND METHODS:
During 1991-1998, a total of 315 LABC patients (cT1-cT4/cN0-N1) were treated with NRT-CHX. Preoperative radiotherapy (RT) consisted of external beam radiation therapy (EBRT) of 50 Gy (5 × 2 Gy/week) to the breast and the supra-/infraclavicular lymph nodes combined with an electron boost in 214 cases afterwards or -in case of breast conservation- a 10-Gy interstitial boost with (192)Ir after loading before EBRT. Chemotherapy was administered prior to RT in 192 patients, and concomitantly in 113; 10 patients received no chemotherapy. The impact of age, tumor grade, nodal status, hormone and growth factor receptor status (ER, PR, EGFR), p53, ki-67, HER2/neu, and bcl-2 on pathological complete response pCR and disease-free survival were examined in uni- and multivariate terms.
RESULTS:
Hormone receptor status, proliferative activity, bcl-2, EGFR-status and clinical tumor size had a significant impact on predicting neoadjuvant therapy success. Age, cN, grading, p53, and HER2/neu status failed to reach a significant correlation to complete remission. All examined immunohistochemical factors with the exception of EGFR, and all clinical factors displayed an univariately significant impact on DFS (disease free survival). Particularly, while HER-2/neu had no predictive value for pCR it displayed the highest impact on DFS after complete response (n = 92), even in a multivariate setting with clinical tumor size and nodal status. Complementary, p53 was the most superior immunhistochemical factor for prognosis after neoadjuvant incomplete remission (n = 223).
CONCLUSION:
Her2/neu is a predictive marker for overall survival independent from the pCR. It has no predictive value for the pCR. P53 is a prognostic marker for patients with incomplete remission. Prospective studies are needed to evaluate their use for decisions to further individualize adjuvant treatment after neoadjuvant radiochemotherapy.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-05-03.
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Affiliation(s)
- C Matuschek
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany; Marien Hospital (MHD), Duesseldorf, NRW, Germany
| | - E Boelke
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany; Marien Hospital (MHD), Duesseldorf, NRW, Germany
| | - C Nestle-Krämling
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany; Marien Hospital (MHD), Duesseldorf, NRW, Germany
| | - V Speer
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany; Marien Hospital (MHD), Duesseldorf, NRW, Germany
| | - H Prisack
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany; Marien Hospital (MHD), Duesseldorf, NRW, Germany
| | - PA Gerber
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany; Marien Hospital (MHD), Duesseldorf, NRW, Germany
| | - H Bojar
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany; Marien Hospital (MHD), Duesseldorf, NRW, Germany
| | - W Audretsch
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany; Marien Hospital (MHD), Duesseldorf, NRW, Germany
| | - S Roth
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany; Marien Hospital (MHD), Duesseldorf, NRW, Germany
| | - W Budach
- Heinrich Heine University, Duesseldorf, NRW, Germany; Institute for Molecular Oncology, Duesseldorf, NRW, Germany; Krankenhaus Gerresheim, Duesseldorf, NRW, Germany; Marien Hospital (MHD), Duesseldorf, NRW, Germany
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Souchon R, Sautter-Bihl ML, Sedlmayer F, Budach W, Dunst J, Feyer P, Fietkau R, Haase W, Harms W, Wenz F, Sauer R. DEGRO practical guidelines: radiotherapy of breast cancer II. Strahlenther Onkol 2013; 190:8-16. [DOI: 10.1007/s00066-013-0502-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [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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Neise D, Sohn D, Stefanski A, Goto H, Inagaki M, Wesselborg S, Budach W, Stühler K, Jänicke RU. The p90 ribosomal S6 kinase (RSK) inhibitor BI-D1870 prevents gamma irradiation-induced apoptosis and mediates senescence via RSK- and p53-independent accumulation of p21WAF1/CIP1. Cell Death Dis 2013; 4:e859. [PMID: 24136223 PMCID: PMC3920941 DOI: 10.1038/cddis.2013.386] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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: 07/15/2013] [Revised: 08/16/2013] [Accepted: 09/05/2013] [Indexed: 01/12/2023]
Abstract
The p90 ribosomal S6 kinase (RSK) family is a group of highly conserved Ser/Thr kinases that promote cell proliferation, growth, motility and survival. As they are almost exclusively activated downstream of extracellular signal-regulated kinases 1 and 2 (ERK1/2), therapeutic intervention by RSK inhibition is less likely to produce such severe side effects as those observed following inhibition of the upstream master regulators Raf, MEK and ERK1/2. Here, we report that BI-D1870, a potent small molecule inhibitor of RSKs, induces apoptosis, although preferentially, in a p21-deficient background. On the other hand, BI-D1870 also induces a strong transcription- and p53-independent accumulation of p21 protein and protects cells from gamma irradiation (γIR)-induced apoptosis, driving them into senescence even in the absence of γIR. Although we identified p21 in in vitro kinase assays as a novel RSK substrate that specifically becomes phosphorylated by RSK1-3 at Ser116 and Ser146, RNA-interference, overexpression and co-immunoprecipitation studies as well as the use of SL0101, another specific RSK inhibitor, revealed that BI-D1870 mediates p21 accumulation via a yet unknown pathway that, besides its off-site targets polo-like kinase-1 and AuroraB, also does also not involve RSKs. Thus, this novel off-target effect of BI-D1870 should be taken into serious consideration in future studies investigating the role of RSKs in cellular signaling and tumorigenesis.
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Affiliation(s)
- D Neise
- Laboratory of Molecular Radiooncology, Clinic and Policlinic for Radiation Therapy and Radiooncology, University of Düsseldorf, Universitätsstrasse 1, Düsseldorf 40225, Germany
| | - D Sohn
- Laboratory of Molecular Radiooncology, Clinic and Policlinic for Radiation Therapy and Radiooncology, University of Düsseldorf, Universitätsstrasse 1, Düsseldorf 40225, Germany
| | - A Stefanski
- Molecular Proteomics Laboratory, BMFZ, University of Düsseldorf, Universitätsstrasse 1, Düsseldorf 40225, Germany
| | - H Goto
- Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi 464-8681, Japan
| | - M Inagaki
- Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi 464-8681, Japan
| | - S Wesselborg
- Institute of Molecular Medicine, University of Düsseldorf, Universitätsstrasse 1, Düsseldorf 40225, Germany
| | - W Budach
- Laboratory of Molecular Radiooncology, Clinic and Policlinic for Radiation Therapy and Radiooncology, University of Düsseldorf, Universitätsstrasse 1, Düsseldorf 40225, Germany
| | - K Stühler
- Molecular Proteomics Laboratory, BMFZ, University of Düsseldorf, Universitätsstrasse 1, Düsseldorf 40225, Germany
| | - R U Jänicke
- Laboratory of Molecular Radiooncology, Clinic and Policlinic for Radiation Therapy and Radiooncology, University of Düsseldorf, Universitätsstrasse 1, Düsseldorf 40225, Germany
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Müller K, Schlamann A, Martini C, Christiansen H, Budach W, Warmuth-Metz M, Rutkowski S, Kortmann R, Fleischhack G, Tippelt S. Role of Craniospinal Radiation Therapy in the Management of Recurrent Medulloblastoma: Experiences From the Prospective German HIT-REZ 1997 and 2005 Studies. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.099] [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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40
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Boelke E, Matuschek C, Janni W, Bojar H, Nestle-Kraemling C, Roth S, Audretsch W, Speer V, Budach W. Long-term Outcomes After Neoadjuvant Chemoradiation Therapy in Locally-Advanced Noninflammatory Breast Cancer and Predictive Factors for a Pathologic Complete Remission: Results of a Multivariate Analysis. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.530] [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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41
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Boelke E, Matuschek C, Geigis C, Scheckenbach K, Hoffmann T, Greve J, Budach W. Prediction of Requirement of Artificial Nutrition by Dosimetric and Clinical Factors in Head-and-Neck Cancer Patients. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1141] [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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42
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Matuschek C, Boelke E, Belka C, Ganswindt U, Henke M, Stegmaier P, Bamberg M, Welz S, Debus J, Budach W. Feasibility of 6 Months Maintenance Cetuximab After Adjuvant Concurrent Chemoradiation Plus Cetuximab in Squamous Cell Carcinoma of the Head and Neck. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Russi E, Bensadoun RJ, Merlano M, Bourhis J, Ricardi U, Giralt J, Pinto C, Budach W, Corvò R, Lacouture M, Bernier J. Bio-radiation dermatitis: the need of a new grading: in regard to Bernier et al: Ann Oncol 2011; 22(10): 2191–2200. Ann Oncol 2013; 24:2463-5. [DOI: 10.1093/annonc/mdt281] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sedlmayer F, Sautter-Bihl M, Budach W, Dunst J, Feyer P, Fietkau R, Haase W, Harms W, Rödel C, Souchon R, Wenz F, Sauer R. Erratum to: Is the simultaneously integrated boost (SIB) technique for early breast cancer ready to be adopted for routine adjuvant radiotherapy? Strahlenther Onkol 2013. [DOI: 10.1007/s00066-013-0349-7] [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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Budach W. SP-0622: Chemoradiation therapy for locally advanced esophageal cancer - European perspective. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32928-5] [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: 10/23/2022]
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46
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Nestle-Krämling C, Haack S, Rezai M, Janni W, Budach W, Boelke E. Bevacizumab in der Brustkrebstherapie – Management schwerer Wundheilungsstörungen. Geburtshilfe Frauenheilkd 2012. [DOI: 10.1055/s-0032-1329439] [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: 10/27/2022] Open
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Matuschek C, Bölke E, Roth SL, Orth K, Lang I, Bojar H, Janni JW, Audretsch W, Nestle-Kraemling C, Lammering G, Speer V, Gripp S, Gerber PA, Buhren BA, Sauer R, Peiper M, Schauer M, Dommach M, Struse-Soll K, Budach W. Long-term outcome after neoadjuvant radiochemotherapy in locally advanced noninflammatory breast cancer and predictive factors for a pathologic complete remission : results of a multivariate analysis. Strahlenther Onkol 2012; 188:777-81. [PMID: 22878547 DOI: 10.1007/s00066-012-0162-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 05/16/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND An earlier published series of neoadjuvant radiochemotherapy (NRT-CHX) in locally advanced noninflammatory breast cancer (LABC) has now been updated with a follow-up of more than 15 years. Long-term outcome data and predictive factors for pathologic complete response (pCR) were analyzed. PATIENTS AND METHODS During 1991-1998, 315 LABC patients (cT1-cT4/cN0-N1) were treated with NRT-CHX. Preoperative radiotherapy (RT) consisted of external beam radiation therapy (EBRT) of 50 Gy (5 × 2 Gy/week) to the breast and the supra-/infraclavicular lymph nodes combined with an electron boost in 214 cases afterwards or-in case of breast conservation-a 10-Gy interstitial boost with (192)Ir afterloading before EBRT. Chemotherapy was administered prior to RT in 192 patients, and concomitantly in 113; 10 patients received no chemotherapy. The update of all follow-up ended in November 2011. Age, tumor grade, nodal status, hormone receptor status, simultaneous vs. sequential CHX, and the time interval between end of RT and surgery were examined in multivariate terms with pCR and overall survival as end point. RESULTS The total pCR rate after neoadjuvant RT-CHX reached 29.2%, with LABC breast conservation becoming possible in 50.8% of cases. In initially node-positive cases (cN+), a complete nodal response (pN0) after NRT-CHX was observed in 56% (89/159). The multivariate analysis revealed that a longer time interval to surgery increased the probability for a pCR (HR 1.17 [95% CI 1.05-1.31], p < 0.01). However, in large tumors (T3-T4) a significantly reduced pCR rate (HR 0.89 [95% CI 0.80-0.99], p = 0.03) was obtained. Importantly, pCR was the strongest prognostic factor for long-term survival (HR 0.28 [95% CI 0.19-0.56], p < 0.001). CONCLUSION pCR identifies patients with a significantly better prognosis for long-term survival. However, a long time interval to surgery (> 2 months) increases the probability of pCR after NRT-CHX.
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Affiliation(s)
- C Matuschek
- Medical Faculty, Department of Radiation Oncology, Heinrich Heine University of Duesseldorf, Germany
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Sautter-Bihl ML, Sedlmayer F, Budach W, Dunst J, Feyer P, Fietkau R, Haase W, Harms W, Rödel C, Souchon R, Wenz F, Sauer R. One life saved by four prevented recurrences? Update of the Early Breast Cancer Trialists confirms: postoperative radiotherapy improves survival after breast conserving surgery. Strahlenther Onkol 2012; 188:461-3. [PMID: 22441440 DOI: 10.1007/s00066-012-0092-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Akanay-Diesel S, Hoff NP, Kürle S, Haes J, Erhardt A, Häussinger D, Schulte KW, Bölke E, Matuschek C, Budach W, Gerber PA, Homey B. Sunitinib induced pyoderma gangrenosum-like ulcerations. Eur J Med Res 2012; 16:491-4. [PMID: 22027642 PMCID: PMC3351806 DOI: 10.1186/2047-783x-16-11-491] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Pyoderma gangrenosum is a non-infectious neutro?philic skin disease commonly associated with underlying systemic diseases. Histopathological and laboratory diagnostics are unspecific in the majority of the cases and the diagnosis is made in accordance with the clinical picture. Here, we report the case of a 69-year old man with progredient pyoderma gangrenosum-like ulcerations under treatment with sunitinib due to hepatocellular carcinoma. A conventional ulcer therapy did not lead to a regression of the lesions. Solely cessation of sunitinib therapy resulted in an improvement of the ulcerations. Sunitinib is a multikinase inhibitor that targets the PDGF-α- and ?β-, VEGF-1-3-, KIT-, FLT3-, CSF-1- and RET-receptor, thereby impairing tumour proliferation, pathological angiogenesis and metastasation. Here, we demonstrate that pyoderma gangrenosum-like ulcers may represent a serious side effect of sunitinib-based anti-cancer treatment.
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Affiliation(s)
- S Akanay-Diesel
- Universitätsklinikum Düsseldorf, Heinrich Heine Universität, Duesseldorf, Germany
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Fietkau R, Budach W, Zamboglou N, Thiel HJ, Sack H, Popp W. Time management in radiation oncology: development and evaluation of a modular system based on the example of rectal cancer treatment. The DEGRO-QUIRO trial. Strahlenther Onkol 2011; 188:5-11. [PMID: 22194028 DOI: 10.1007/s00066-011-0003-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 09/06/2011] [Indexed: 11/26/2022]
Abstract
PURPOSE The goal was to develop and evaluate a modular system for measurement of the work times required by the various professional groups involved in radiation oncology before, during, and after serial radiation treatment (long-term irradiation with 25-28 fractions of 1.8 Gy) based on the example of rectal cancer treatment. MATERIALS AND METHODS A panel of experts divided the work associated with providing radiation oncology treatment into modules (from the preparation of radiotherapy, RT planning and administration to the final examination and follow-up). The time required for completion of each module was measured by independent observers at four centers (Rostock, Bamberg, Düsseldorf, and Offenbach, Germany). RESULTS A total of 1,769 data sets were collected from 63 patients with 10-489 data sets per module. Some modules (informed consent procedure, routine treatments, CT planning) exhibited little deviation between centers, whereas others (especially medical and physical irradiation planning) exhibited a wide range of variation (e.g., 1 h 49 min to 6 h 56 min for physical irradiation planning). The mean work time per patient was 12 h 11 min for technicians, 2 h 59 min for physicists, and 7 h 6 min for physicians. CONCLUSION The modular system of time measurement proved to be reliable and produced comparable data at the different centers. Therefore, the German Society of Radiation Oncology (DEGRO) decided that it can be extended to other types of cancer (head and neck, prostate, and breast cancer) with appropriate modifications.
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Affiliation(s)
- R Fietkau
- Department of Radiation Oncology, Erlangen University Hospital, Universitätsstr. 27, 91054, Erlangen, Germany.
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