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  • 1
    Language: English
    In: International journal of radiation oncology, biology, physics, 2012, Vol.83 (3), p.859-864
    Description: Purpose Previously, we could show that the new World Health Organization (WHO) classification of meningiomas significantly correlated with outcome in patients with atypical and anaplastic histology. In the present work, we analyzed our long-term experience in radiotherapy for atypical and malignant meningioma diagnosed according to the most recent WHO categorization system. Patients and Methods Sixty-two patients with atypical and 23 patients with malignant meningioma have been treated with radiotherapy. Sixty percent of all patients received radiotherapy (RT) after surgical resection, 19% at disease progression and 8.3% as a primary treatment. Radiation was applied using different techniques including fractionated stereotactic RT (FSRT), intensity-modulated RT, and combination treatment with carbon ions. The median PTV was 156.0 mL. An average dose of 57.6 Gy (range, 30–68.4 Gy) in 1.8–3 Gy fractions was applied. All patients were followed regularly including clinical-neurological follow-up as well as computed tomographies or magnetic resonance imaging. Results Overall survival was impacted significantly by histological grade, with 81% and 53% at 5 years for atypical or anaplastic meningiomas, respectively. This difference was significant at p = 0.022. Eighteen patients died of tumor progression during follow-up. Progression-free survival was 95% and 50% for atypical, and 63% and 13% for anaplastic histology at 2 and 5 years. This difference was significant at p = 0.017. Despite histology, we could not observe any prognostic factors including age, resection status, or Karnofsky performance score. However, preexisting clinical symptoms observed in 63 patients improved in 29.3% of these patients. Conclusion RT resulted in improvement of preexisting clinical symptoms; outcome is comparable to other series reported in the literature. RT should be offered after surgical resection after initial diagnosis to increase progression-free survival as well as overall survival. Novel clinical concepts are under investigation to further improve outcome in patients with high-grade meningiomas.
    Subject(s): Radiology ; Hematology, Oncology and Palliative Medicine ; Radiation therapy ; Outcome ; High-risk meningiomas ; Prognostic factors ; Neurology ; Biological and medical sciences ; Medical sciences ; Tumors of the nervous system. Phacomatoses ; Prognosis ; Humans ; Meningioma - surgery ; Middle Aged ; Radiotherapy, Intensity-Modulated - methods ; Carbon Radioisotopes - therapeutic use ; Male ; Treatment Outcome ; Disease Progression ; Meningeal Neoplasms - mortality ; Disease-Free Survival ; Meningioma - pathology ; Karnofsky Performance Status ; Meningeal Neoplasms - surgery ; Dose Fractionation ; Female ; Meningeal Neoplasms - radiotherapy ; Meningioma - radiotherapy ; Meningeal Neoplasms - pathology ; Radiosurgery - methods ; Radiotherapy, Adjuvant ; Meningioma - mortality ; Practice Guidelines as Topic ; Nuclear radiation ; Oncology, Experimental ; Radiation ; Research ; Universities and colleges ; Radiotherapy ; Public health ; Cancer ; Index Medicus ; SURGERY ; DIAGNOSIS ; PATIENTS ; NEOPLASMS ; PERFORMANCE ; CLASSIFICATION ; RADIATION DOSES ; SYMPTOMS ; HISTOLOGY ; COMPUTERIZED TOMOGRAPHY ; GY RANGE 10-100 ; NMR IMAGING ; RECOMMENDATIONS ; RADIOLOGY AND NUCLEAR MEDICINE ; CARBON IONS ; RADIOTHERAPY ; HAZARDS
    ISSN: 0360-3016
    E-ISSN: 1879-355X
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  • 2
    Language: English
    In: International journal of radiation oncology, biology, physics, 2007, Vol.68 (2), p.449-457
    Description: Purpose: The aim of this study was to evaluate the effectiveness and toxicity of carbon ion radiotherapy in chordomas of the skull base. Methods and Materials: Between November 1998 and July 2005, a total of 96 patients with chordomas of the skull base have been treated with carbon ion radiation therapy (RT) using the raster scan technique at the Gesellschaft für Schwerionenforschung (GSI) in Darmstadt, Germany. All patients had gross residual tumors. Median total dose was 60 CGE (range, 60–70 CGE) delivered in 20 fractions within 3 weeks. Local control and overall survival rates were calculated using the Kaplan-Meier method. Toxicity was assessed according to the Common Terminology Criteria (CTCAE v.3.0) and the Radiation Therapy Oncology Group (RTOG) / European Organization for Research and Treatment of Cancer (EORTC) score. Results: Mean follow-up was 31 months (range, 3–91 months). Fifteen patients developed local recurrences after carbon ion RT. The actuarial local control rates were 80.6% and 70.0% at 3 and 5 years, respectively. Target doses in excess of 60 CGE and primary tumor status were associated with higher local control rates. Overall survival was 91.8% and 88.5% at 3 and 5 years, respectively. Late toxicity consisted of optic nerve neuropathy RTOG/EORTC Grade 3 in 4.1% of the patients and necrosis of a fat plomb in 1 patient. Minor temporal lobe injury (RTOG/EORTC Grade 1–2) occurred in 7 patients (7.2%). Conclusions: Carbon ion RT offers an effective treatment option for skull-base chordomas with acceptable toxicity. Doses in excess of 75 CGE with 2 CGE per fraction are likely to increase local control probability.
    Subject(s): Radiology ; Hematology, Oncology and Palliative Medicine ; Carbon ion radiation therapy ; Active beam delivery ; Particle therapy ; Skull-base chordoma ; Radiotherapy Dosage ; Follow-Up Studies ; Chordoma - radiotherapy ; Humans ; Middle Aged ; Carbon Radioisotopes - therapeutic use ; Neoplasm Recurrence, Local ; Child, Preschool ; Male ; Skull Base Neoplasms - mortality ; Radiation Injuries - etiology ; Neoplasm, Residual ; Carbon Radioisotopes - adverse effects ; Skull Base Neoplasms - radiotherapy ; Adolescent ; Survival Analysis ; Adult ; Female ; Aged ; Chordoma - mortality ; Child ; Dose-Response Relationship, Radiation ; Radiotherapy ; PATIENTS ; INJURIES ; NECROSIS ; BEAMS ; CARCINOMAS ; RADIOLOGY AND NUCLEAR MEDICINE ; SKULL ; FATS ; RADIATION DOSES ; TOXICITY ; CARBON IONS ; RADIOTHERAPY
    ISSN: 0360-3016
    E-ISSN: 1879-355X
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  • 3
    Language: English
    In: International journal of radiation oncology, biology, physics, 2008, Vol.70 (4), p.987-992
    Description: Purpose To evaluate efficacy and toxicity in elderly patients with glioblastoma multiforme (GBM) treated with postoperative radiochemotherapy with temozolomide (TMZ). Patients and Methods Forty-three patients aged 65 years or older were treated with postoperative with radiochemotherapy using TMZ for primary GBM. Median age at primary diagnosis was 67 years; 14 patients were female, 29 were male. A complete surgical resection was performed in 12 patients, subtotal resection in 17 patients, and biopsy only in 14 patients. Radiotherapy was applied with a median dose of 60 Gy, in a median fractionation of 5 × 2 Gy/wk. Thirty-five patients received concomitant TMZ at 50 mg/m2 , and in 8 patients 75 mg/m2 of TMZ was applied. Adjuvant cycles of TMZ were prescribed in 5 patients only. Results Median overall survival was 11 months in all patients; the actuarial overall survival rate was 48% at 1 year and 8% at 2 years. Median overall survival was 18 months after complete resection, 16 months after subtotal resection, and 6 months after biopsy only. Median progression-free survival was 4 months; the actuarial progression-free survival rate was 41% at 6 months and 18% at 12 months. Radiochemotherapy was well tolerated in most patients and could be completed without interruption in 38 of 43 patients. Four patients developed hematologic side effects greater than Common Terminology Criteria Grade 2, which led to early discontinuation of TMZ in 1 patient. Conclusions Radiochemotherapy is safe and effective in a subgroup of elderly patients with GBM and should be considered in patients without major comorbidities.
    Subject(s): Radiology ; Hematology, Oncology and Palliative Medicine ; Chemotherapy ; Glioblastoma multiforme ; Elderly patients ; Outcome ; Radiation ; Dacarbazine - therapeutic use ; Humans ; Male ; Combined Modality Therapy ; Brain Neoplasms - drug therapy ; Glioblastoma - radiotherapy ; Brain Neoplasms - surgery ; Glioblastoma - surgery ; Antineoplastic Agents, Alkylating - therapeutic use ; Dacarbazine - analogs & derivatives ; Survival Analysis ; Female ; Aged ; Brain Neoplasms - radiotherapy ; Glioblastoma - drug therapy ; Aged patients ; Care and treatment ; Temozolomide ; Radiotherapy ; GLIOMAS ; SURGERY ; DIAGNOSIS ; PATIENTS ; ELDERLY PEOPLE ; BIOPSY ; RADIATION DOSES ; TOXICITY ; CHEMOTHERAPY ; FRACTIONATED IRRADIATION ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; SIDE EFFECTS
    ISSN: 0360-3016
    E-ISSN: 1879-355X
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  • 4
    Language: English
    In: International journal of radiation oncology, biology, physics, 2010, Vol.76 (1), p.193-200
    Description: Purpose To evaluate the outcomes of patients with vestibular schwannoma (VS) treated with fractionated stereotactic radiotherapy (FSRT) vs. those treated with stereotactic radiosurgery (SRS). Methods and Materials This study is based on an analysis of 200 patients with 202 VSs treated with FSRT ( n = 172) or SRS ( n = 30). Patients with tumor progression and/or progression of clinical symptoms were selected for treatment. In 165 out of 202 VSs (82%), RT was performed as the primary treatment for VS, and for 37 VSs (18%), RT was conducted for tumor progression after neurosurgical intervention. For patients receiving FSRT, a median total dose of 57.6 Gy was prescribed, with a median fractionation of 5 x 1.8 Gy per week. For patients who underwent SRS, a median single dose of 13 Gy was prescribed to the 80% isodose. Results FSRT and SRS were well tolerated. Median follow-up time was 75 months. Local control was not statistically different for both groups. The probability of maintaining the pretreatment hearing level after SRS with doses of ≤13 Gy was comparable to that of FSRT. The radiation dose for the SRS group (≤13 Gy vs. 〉13 Gy) significantly influenced hearing preservation rates ( p = 0.03). In the group of patients treated with SRS doses of ≤13 Gy, cranial nerve toxicity was comparable to that of the FSRT group. Conclusions FSRT and SRS are both safe and effective alternatives for the treatment of VS. Local control rates are comparable in both groups. SRS with doses of ≤13 Gy is a safe alternative to FSRT. While FSRT can be applied safely for the treatment of VSs of all sizes, SRS should be reserved for smaller lesions.
    Subject(s): Radiology ; Hematology, Oncology and Palliative Medicine ; Precision radiotherapy ; Acoustic neuroma ; Local control ; Hearing preservation ; Facial Nerve - radiation effects ; Follow-Up Studies ; Humans ; Neuroma, Acoustic - surgery ; Dose Fractionation ; Female ; Male ; Neuroma, Acoustic - pathology ; Trigeminal Nerve - radiation effects ; Radiosurgery - methods ; Radiosurgery - adverse effects ; Hearing - radiation effects ; Research ; Radiotherapy ; Oncology, Experimental ; Cancer ; SURGERY ; NEOPLASMS ; NERVES ; NERVOUS SYSTEM ; RADIATION DOSES ; HEARINGS ; MEDICINE ; DOCUMENT TYPES ; NUCLEAR MEDICINE ; LINEAR ACCELERATORS ; IRRADIATION ; FRACTIONATED IRRADIATION ; DISEASES ; THERAPY ; DOSES ; ACCELERATORS ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; RADIOLOGY ; CONTROL
    ISSN: 0360-3016
    E-ISSN: 1879-355X
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  • 5
    Language: English
    In: International journal of radiation oncology, biology, physics, 2007, Vol.67 (1), p.171-177
    Description: Purpose: To evaluate the effectiveness and toxicity of carbon ion radiotherapy in chondrosarcomas of the skull base. Patients and Methods: Between November 1998 and September 2005, 54 patients with low-grade and intermediate-grade chondrosarcomas of the skull base have been treated with carbon ion radiation therapy (RT) using the raster scan technique at the Gesellschaft für Schwerionenforschung in Darmstadt, Germany. All patients had gross residual tumors after surgery. Median total dose was 60 CGE (weekly fractionation 7 × 3.0 CGE). All patients were followed prospectively in regular intervals after treatment. Local control and overall survival rates were calculated using the Kaplan-Meier method. Toxicity was assessed according to the Common Terminology Criteria (CTCAE v.3.0) and the Radiation Therapy Oncology Group (RTOG)/European Organization for Research and Treatment of Cancer (EORTC) score. Results: Median follow-up was 33 months (range, 3–84 months). Only 2 patients developed local recurrences. The actuarial local control rates were 96.2% and 89.8% at 3 and 4 years; overall survival was 98.2%at 5 years. Only 1 patient developed a mucositis CTCAE Grade 3; the remaining patients did not develop any acute toxicities 〉CTCAE Grade 2. Five patients developed minor late toxicities (RTOG/EORTC Grades 1–2), including bilateral cataract ( n = 1), sensory hearing loss ( n = 1), a reduction of growth hormone ( n = 1), and asymptomatic radiation-induced white matter changes of the adjacent temporal lobe ( n = 2). Grade 3 late toxicity occurred in 1 patient (1.9%) only. Conclusions: Carbon ion RT is an effective treatment for low- and intermediate-grade chondrosarcomas of the skull base offering high local control rates with low toxicity.
    Subject(s): Radiology ; Hematology, Oncology and Palliative Medicine ; Carbon ion radiation therapy ; Chondrosarcoma ; Skull base ; Particle therapy ; Radiotherapy Dosage ; Carbon Isotopes - therapeutic use ; Neoplasm Recurrence, Local - radiotherapy ; Follow-Up Studies ; Chondrosarcoma - mortality ; Humans ; Middle Aged ; Carbon Isotopes - adverse effects ; Salvage Therapy ; Protons - therapeutic use ; Male ; Survival Rate ; Skull Base Neoplasms - mortality ; Neoplasm, Residual ; Skull Base Neoplasms - radiotherapy ; Adolescent ; Adult ; Female ; Aged ; Child ; Chondrosarcoma - radiotherapy ; Radiotherapy ; SURGERY ; PATIENTS ; CATARACTS ; STH ; SKELETAL DISEASES ; SKULL ; RADIATION DOSES ; TOXICITY ; FRACTIONATED IRRADIATION ; SARCOMAS ; RADIOLOGY AND NUCLEAR MEDICINE ; CARBON IONS ; RADIOTHERAPY
    ISSN: 0360-3016
    E-ISSN: 1879-355X
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  • 6
    Language: English
    In: International journal of radiation oncology, biology, physics, 2011, Vol.81 (5), p.1415-1421
    Description: Purpose To evaluate the correlation between the 1993 and 2000/2007 World Health Organization (WHO) classification with the outcome in patients with high-grade meningiomas. Patients and Methods Between 1985 and 2004, 73 patients diagnosed with atypical or anaplastic meningiomas were treated with radiotherapy. Sections from the paraffin-embedded tumor material from 66 patients (90%) from 13 different pathology departments were re-evaluated according to the first revised WHO classification from 1993 and the revised classifications from 2000/2007. In 4 cases, the initial diagnosis meningioma was not reproducible (5%). Therefore, 62 patients with meningiomas were analyzed. Results All 62 tumors were reclassified according to the 1993 and 2000/2007 WHO classification systems. Using the 1993 system, 7 patients were diagnosed with WHO grade I meningioma (11%), 23 with WHO grade II (37%), and 32 with WHO grade III meningioma (52%). After scoring using the 2000/2007 system, we found 17 WHO grade I meningiomas (27%), 32 WHO grade II meningiomas (52%), and 13 WHO grade III meningiomas (21%). According to the 1993 classification, the difference in overall survival was not statistically significant among the histologic subgroups ( p = .96). Using the 2000/2007 WHO classifications, the difference in overall survival became significant ( p = .02). Of the 62 reclassified patients 29 developed tumor progression (47%). No difference in progression-free survival was observed among the histologic subgroups ( p = .44). After grading according to the 2000/2007 WHO classifications, significant differences in progression-free survival were observed among the three histologic groups ( p = .005). Conclusion The new 2000/2007 WHO classification for meningiomas showed an improved correlation between the histologic grade and outcome. This classification therefore provides a useful basis to determine the postoperative indication for radiotherapy. According to our results, a comparison of the published data for future treatment decision-making remains difficult when the histologic diagnosis has not been based on the new improved classification system.
    Subject(s): Radiology ; Hematology, Oncology and Palliative Medicine ; Neurology ; Biological and medical sciences ; Medical sciences ; Tumors of the nervous system. Phacomatoses ; Meningeal Neoplasms - classification ; World Health Organization ; Humans ; Middle Aged ; Meningioma - classification ; Male ; Disease Progression ; Meningeal Neoplasms - mortality ; Neoplasm Staging - methods ; Young Adult ; Meningioma - pathology ; Adolescent ; Survival Analysis ; Aged, 80 and over ; Adult ; Female ; Aged ; Meningeal Neoplasms - radiotherapy ; Meningioma - radiotherapy ; Meningeal Neoplasms - pathology ; Meningioma - mortality ; Peace movements ; Oncology, Experimental ; Research ; Universities and colleges ; Radiotherapy ; Public health ; Cancer ; Index Medicus ; PARAFFIN ; DIAGNOSIS ; MENINGES ; PATIENTS ; NEOPLASMS ; NEUROLOGY ; DECISION MAKING ; RADIOLOGY AND NUCLEAR MEDICINE ; CLASSIFICATION ; PATHOLOGY ; RADIOTHERAPY ; WHO
    ISSN: 0360-3016
    E-ISSN: 1879-355X
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  • 7
    Language: English
    In: International journal of radiation oncology, biology, physics, 2011, Vol.81 (3), p.e7-e13
    Description: Purpose To investigate treatment outcome and prognostic factors after radiation therapy in patients with medulloblastomas (MB). Methods and Materials Sixty-six patients with histologically confirmed MB were treated at the University Hospital of Heidelberg between 1985 and 2009. Forty-two patients (64%) were pediatric (≤18 years), and 24 patients (36%) were adults. Tumor resection was performed in all patients and was complete in 47%. All patients underwent postoperative craniospinal irradiation (CSI) delivering a median craniospinal dose of 35.5 Gy with additional boosts to the posterior fossa up to 54.0 Gy. Forty-seven patients received chemotherapy, including 21 in whom chemotherapy was administered before CSI. Statistical analysis was performed using the log-rank test and the Kaplan-Meier method. Results Median follow-up was 93 months. Overall survival (OS) and local and distant progression-free survival (LPFS and DPFS) were 73%, 62%, and 77% at 60 months. Both local and distant recurrence predisposed for significantly reduced OS. Macroscopic complete tumor resection, desmoplastic histology and early initiation of postoperative radiation therapy within 28 days were associated with improved outcome. The addition of chemotherapy did not improve survival rates. Toxicity was moderate. Conclusions Complete resection of MB followed by CSI yields long survival rates in both children and adults. Delayed initiation of CSI is associated with poor outcome. Desmoplastic histology is associated with improved survival. The role of chemotherapy, especially in the adult population, must be further investigated in clinical studies.
    Subject(s): Radiology ; Hematology, Oncology and Palliative Medicine ; Craniospinal irradiation ; Medulloblastoma ; Prognostic factors ; Radiochemotherapy ; Recurrence ; Prognosis ; Age Factors ; Follow-Up Studies ; Humans ; Middle Aged ; Child, Preschool ; Male ; Medulloblastoma - therapy ; Medulloblastoma - mortality ; Cranial Irradiation - methods ; Young Adult ; Medulloblastoma - radiotherapy ; Medulloblastoma - pathology ; Adult ; Female ; Retrospective Studies ; Cerebellar Neoplasms - pathology ; Child ; Radiotherapy Dosage ; Cerebellar Neoplasms - mortality ; Treatment Outcome ; Drug Therapy, Combination - methods ; Analysis of Variance ; Adolescent ; Cerebellar Neoplasms - therapy ; Cerebellar Neoplasms - radiotherapy ; Germany ; Care and treatment ; Radiotherapy ; Gliomas ; Radiation ; ANIMALS ; NEOPLASMS ; ADULTS ; RADIATION DOSES ; TOXICITY ; HISTOLOGY ; MEDICINE ; PRIMATES ; CHEMOTHERAPY ; NUCLEAR MEDICINE ; CHILDREN ; IRRADIATION ; DISEASES ; THERAPY ; DOSES ; VERTEBRATES ; RADIOLOGY AND NUCLEAR MEDICINE ; PEDIATRICS ; RADIOTHERAPY ; MAN ; AGE GROUPS ; RADIOLOGY ; MAMMALS
    ISSN: 0360-3016
    E-ISSN: 1879-355X
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  • 8
    Language: English
    In: International journal of radiation oncology, biology, physics, 2012, Vol.83 (1), p.394-399
    Description: Purpose To investigate the effect of carbon ion irradiation on glioma cell migration. Methods and Materials U87 and Ln229 glioma cells were irradiated with photons and carbon ions. Migration was analyzed 24 h after irradiation. Fluorescence-activated cell sorting analysis was performed in order to quantify surface expression of integrins. Results Single photon doses of 2 Gy and 10 Gy enhanced αν β3 and αν β5 integrin expression and caused tumor cell hypermigration on both vitronectin (Vn) and fibronectin (Fn). Compared to integrin expression in unirradiated cells, carbon ion irradiation caused decreased integrin expression and inhibited cell migration on both Vn and Fn. Conclusion Photon radiotherapy (RT) enhances the risk of tumor cell migration and subsequently promotes locoregional spread via photon induction of integrin expression. In contrast to photon RT, carbon ion RT causes decreased integrin expression and suppresses glioma cell migration on both Vn and Fn, thus promising improved local control.
    Subject(s): Radiology ; Hematology, Oncology and Palliative Medicine ; Integrin ; Glioma ; Radiotherapy ; Migration ; Particle therapy ; Neurology ; Biological and medical sciences ; Medical sciences ; Tumors of the nervous system. Phacomatoses ; Carbon - therapeutic use ; Photons - adverse effects ; Humans ; Radiation Dosage ; Down-Regulation - radiation effects ; Neoplasm Proteins - metabolism ; Glioma - radiotherapy ; Cell Movement - physiology ; Integrin alphaVbeta3 - metabolism ; Photons - therapeutic use ; Cell Movement - radiation effects ; Glioma - metabolism ; Down-Regulation - physiology ; Neoplasm Proteins - radiation effects ; Glioma - pathology ; Receptors, Vitronectin - radiation effects ; Integrin alphaVbeta3 - radiation effects ; Cell Line, Tumor ; Fibronectins - physiology ; Receptors, Vitronectin - metabolism ; Vitronectin - physiology ; Nuclear radiation ; Gliomas ; Cells ; Radiation ; Integrins ; Index Medicus ; GLIOMAS ; IRRADIATION ; FLUORESCENCE ; PHOTONS ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIATION DOSES ; TUMOR CELLS ; RADIOTHERAPY ; HAZARDS
    ISSN: 0360-3016
    E-ISSN: 1879-355X
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  • 9
    Language: English
    In: International journal of radiation oncology, biology, physics, 2011, Vol.81 (5), p.e793-e801
    Description: Puropose To asses early toxicity and response in 118 patients treated with scanned ion beams to validate the safety of intensity-controlled raster scanning at the Heidelberg Ion Therapy Center. Patients and Methods Between November 2009 and June 2010, we treated 118 patients with proton and carbon ion radiotherapy (RT) using active beam delivery. The main indications included skull base chordomas and chondrosarcomas, salivary gland tumors, and gliomas. We evaluated early toxicity within 6 weeks after RT and the initial clinical and radiologic response for quality assurance in our new facility. Results In all 118 patients, few side effects were observed, in particular, no high numbers of severe acute toxicity were found. In general, the patients treated with particle therapy alone showed only a few single side effects, mainly Radiation Therapy Oncology Group/Common Terminology Criteria grade 1. The most frequent side effects and cumulative incidence of single side effects were observed in the head-and-neck patients treated with particle therapy as a boost and photon intensity-modulated RT. The toxicities included common radiation-attributed reactions known from photon RT, including mucositis, dysphagia, and skin erythema. The most predominant imaging responses were observed in patients with high-grade gliomas and those with salivary gland tumors. For skull base tumors, imaging showed a stable tumor outline in most patients. Thirteen patients showed improvement of pre-existing clinical symptoms. Conclusions Side effects related to particle treatment were rare, and the overall tolerability of the treatment was shown. The initial response was promising. The data have confirmed the safe delivery of carbon ions and protons at the newly opened Heidelberg facility.
    Subject(s): Radiology ; Hematology, Oncology and Palliative Medicine ; Beam scanning ; Proton therapy ; Raster scanning ; Toxicity ; Carbon ion radiotherapy ; Prospective Studies ; Protons - adverse effects ; Chordoma - radiotherapy ; Humans ; Middle Aged ; Protons - therapeutic use ; Male ; Glioma - radiotherapy ; Incidence ; Young Adult ; Erythema - etiology ; Skull Base Neoplasms - radiotherapy ; Adult ; Deglutition Disorders - etiology ; Female ; Neoplasms - radiotherapy ; Mucositis - epidemiology ; Brain Neoplasms - radiotherapy ; Child ; Chondrosarcoma - radiotherapy ; Carbon - therapeutic use ; Photons - adverse effects ; Deglutition Disorders - epidemiology ; Treatment Outcome ; Erythema - epidemiology ; Photons - therapeutic use ; Magnetic Resonance Imaging ; Radiation Injuries - epidemiology ; Bone Neoplasms - radiotherapy ; Mucositis - etiology ; Adolescent ; Salivary Gland Neoplasms - radiotherapy ; Aged ; Germany ; Carbon - adverse effects ; Image processing ; Oncology, Experimental ; Analysis ; Radiation ; Equipment and supplies ; Research ; Printing industry ; Methods ; Cancer ; GLIOMAS ; HEAD ; PATIENTS ; QUALITY ASSURANCE ; PHOTONS ; ION BEAMS ; SALIVARY GLANDS ; SKELETAL DISEASES ; ERYTHEMA ; SKULL ; TOXICITY ; PROTONS ; SARCOMAS ; RADIOLOGY AND NUCLEAR MEDICINE ; CARBON IONS ; NECK ; RADIOTHERAPY ; SKIN ; SIDE EFFECTS
    ISSN: 0360-3016
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  • 10
    Language: English
    In: International journal of radiation oncology, biology, physics, 2008, Vol.71 (4), p.999-1005
    Description: Purpose To evaluate toxicity and outcomes in patients with primary glioblastoma (GB) treated with postoperative radiochemotherapy (RCHT) with temozolomide (TMZ) comparing two dose regimens. Methods and Materials A total of 160 patients with histologically confirmed GB were treated with postoperative RCHT with TMZ. Of the patients, 66 were female and 94 were male, with a median age of 60 years. After the primary diagnosis, a biopsy had been performed in 42 patients; a subtotal and total resection was conducted in 66 and 52 patients. Postoperative radiotherapy was applied with a median dose of 60 Gy with a median fractionation of 5 × 2Gy/week. Concomitant TMZ was prescribed at 50 mg/m2 in 123 patients (Group A) and at 75 mg/m2 in 37 patients (Group B). Patients were followed in 3-months intervals, with a median follow-up of 13 months. Results Overall survival (OS) rates in Group A vs. Group B were 67% and 79% at 1 year and 43% vs. 49% at 2 years, respectively ( p = 0.69). Progression-free survival was 49% vs. 54% at 1 year and 22% vs. 29% at 2 years ( p = 0.31). Hematologic toxicity was not statistically significant over the 6-week RCHT period except for a significant decrease in platelets during Week 6 ( p = 0.01) in Group B. Conclusions Overall survival seems to be comparable in both groups, although longer follow-up and a larger group of patients are needed to corroborate these results. Lower dosing of TMZ also is associated with a more beneficial toxicity profile.
    Subject(s): Radiology ; Hematology, Oncology and Palliative Medicine ; Temozolomide ; Toxicity ; Outcome ; Glioblastoma ; Radiochemotherapy ; Risk Assessment - methods ; Dacarbazine - administration & dosage ; Prevalence ; Radiotherapy - mortality ; Drug Administration Schedule ; Humans ; Middle Aged ; Risk Factors ; Male ; Survival Rate ; Treatment Outcome ; Antineoplastic Agents, Alkylating - administration & dosage ; Germany - epidemiology ; Dose-Response Relationship, Drug ; Glioblastoma - therapy ; Brain Neoplasms - therapy ; Dacarbazine - analogs & derivatives ; Survival Analysis ; Adult ; Female ; Aged ; Brain Neoplasms - mortality ; Combined Modality Therapy - statistics & numerical data ; Glioblastoma - mortality ; GLIOMAS ; DIAGNOSIS ; PATIENTS ; FRACTIONATION ; BIOPSY ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIATION DOSES ; TOXICITY ; RADIOTHERAPY
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