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  1. Book ; Thesis: Morphologische und funktionelle Untersuchungen zu vaskulären Spätveränderungen nach stereotaktischer Bestrahlung des Rattengehirns

    Münter, Marc

    1998  

    Author's details vorgelegt von Marc W. Münter
    Language German
    Size II, 127 Bl. : Ill., graph. Darst.
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Heidelberg, Univ., Diss., 1999
    HBZ-ID HT011153770
    Database Catalogue ZB MED Medicine, Health

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  2. Article ; Online: Cetuximab, gemcitabine and radiotherapy in locally advanced pancreatic cancer: Long-term results of the randomized controlled phase II PARC trial.

    Liermann, Jakob / Munter, Marc / Naumann, Patrick / Abdollahi, Amir / Krempien, Robert / Debus, Juergen

    Clinical and translational radiation oncology

    2022  Volume 34, Page(s) 15–22

    Abstract: Purpose: Addressing the epidermal growth factor receptor (EGFR)-pathway by the competitive receptor ligand cetuximab is a promising strategy in pancreatic cancer. In the prospective randomized controlled phase II PARC-study (PARC: Pancreatic cancer ... ...

    Abstract Purpose: Addressing the epidermal growth factor receptor (EGFR)-pathway by the competitive receptor ligand cetuximab is a promising strategy in pancreatic cancer. In the prospective randomized controlled phase II PARC-study (PARC: Pancreatic cancer treatment with radiotherapy (RT) and cetuximab), we evaluated safety and efficacy of a trimodal treatment scheme consisting of cetuximab, gemcitabine and RT in locally advanced pancreatic cancer (LAPC).
    Methods: Between January 2005 and April 2007, 68 patients with inoperable pancreatic ductal adenocarcinoma were randomized in either trimodal therapy followed by gemcitabine maintenance (Arm A) or in trimodal therapy followed by gemcitabine plus cetuximab maintenance (Arm B). Intensity-modulated RT (IMRT) was performed with a total dose of 45 Gy in 25 fractions and with a simultaneous integrated boost to the gross tumor (54 Gy). Within the trimodal therapy, gemcitabine and cetuximab were administered weekly. Maintenance therapy consisted of gemcitabine only or gemcitabine plus cetuximab. Toxicity, overall survival (OS), secondary resection rate, local control and progression free survival (PFS) were evaluated.
    Results: With a median followup time of 13 months (range: 2 - 184 months), one patient is still alive and one patient is lost to follow-up. Nausea and gastrointestinal hemorrhage were the most important higher-graded (>°II) acute and late non-hematological toxicity (13% and 7%). Median OS was 13.1 months without significant difference between both treatment arms (Arm A: 11.9 months; Arm B: 14.2 months). Compared to historical data, cetuximab did not improve OS. One- and two-year local control rates were 76.6% and 68.9%. Local tumor control and secondary resection rate (Arm A: 4%; Arm B: 16%) were significantly improved in Arm B. Median PFS was 6.8 months with distant metastasis as main treatment failure.
    Conclusion: Trimodal therapy consisting of IMRT, gemcitabine and cetuximab can be considered safe and feasible. Compared to historical data, cetuximab does not improve treatment efficacy in LAPC patients treated with chemoradiation.
    Language English
    Publishing date 2022-03-09
    Publishing country Ireland
    Document type Journal Article
    ISSN 2405-6308
    ISSN (online) 2405-6308
    DOI 10.1016/j.ctro.2022.03.003
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  3. Article: PET/CT in der Strahlentherapie

    Krempien, Robert / Münter, Marc / Dresel, Stefan

    Der Nuklearmediziner

    2020  Volume 43, Issue 02, Page(s) 167–183

    Abstract: Das therapeutische Konzept einer suffizienten Strahlentherapie ist die Applikation einer ausreichend hohen therapeutischen Dosis im anvisierten Zielvolumen bei gleichzeitiger maximaler Schonung des umgebenden Normalgewebes. Es zeigt sich jedoch mehr und ... ...

    Abstract Das therapeutische Konzept einer suffizienten Strahlentherapie ist die Applikation einer ausreichend hohen therapeutischen Dosis im anvisierten Zielvolumen bei gleichzeitiger maximaler Schonung des umgebenden Normalgewebes. Es zeigt sich jedoch mehr und mehr, dass die traditionellen Anatomie-basierten Schnittbildgebungen (CT, MRT) die Tumorausdehnung häufig über- oder unterbewerten. Seit der Einführung der Positronen-Emissions-Tomografie (PET) in die klinische Routine wird angestrebt, die morphologische Basis der Bestrahlungsplanungs-CT durch die funktionellen Informationen der PET zu ergänzen und somit zu einer biologisch funktionellen Bestrahlungsplanung zu gelangen. Durch eine präzise Koregistrierung der funktionellen, metabolischen Daten mit den für die Bestrahlungsplanung erforderlichen anatomischen Informationen aus den CT-Aufnahmen kommt die PET/CT-Technik den Anforderungen der Hochpräzisionsbestrahlung entscheidend entgegen. Klinische Studien bei nahezu allen Tumorentitäten zeigen einen erheblichen Einfluss der PET/CT auf die Konturierung der Zielvolumina. Erhebliche Änderungen zeigen sich in 20 % bis über 50 % der Fälle gegenüber rein CT-basierten Konturierungen. Im Folgenden haben wir die wesentlichen Daten in Bezug auf Staging und Zielvolumendefinition und soweit vorhanden auf Therapieansprechen zusammengefasst.
    Keywords PET/CT ; Strahlentherapie ; PET/CT ; radiotherapy
    Language German
    Publishing date 2020-05-28
    Publisher © Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2092413-6
    ISSN 1439-5800 ; 0723-7065
    ISSN (online) 1439-5800
    ISSN 0723-7065
    DOI 10.1055/a-0959-0635
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  4. Article ; Online: Combined Photon and Carbon Ion Radiation Therapy for Sinonasal Malignancies: Results of the HIT-SNT Prospective Phase 2 Trial.

    Weusthof, Katharina / Held, Thomas / Lang, Kristin / Rachel, Zoe E / Harrabi, Semi B / Plath, Karim / Freudlsperger, Christian / Herfarth, Klaus / Debus, Jürgen / Haberer, Thomas / Münter, Marc / Jensen, Alexandra D / Adeberg, Sebastian

    International journal of radiation oncology, biology, physics

    2023  Volume 118, Issue 5, Page(s) 1563–1574

    Abstract: Purpose: Radiation treatment of sinonasal malignancies is a challenging task due to proximity to critical structures of the head and neck and skull base. Local tumor control is highly dose-dependent, but dose application is limited due to accompanying ... ...

    Abstract Purpose: Radiation treatment of sinonasal malignancies is a challenging task due to proximity to critical structures of the head and neck and skull base. Local tumor control is highly dose-dependent, but dose application is limited due to accompanying toxicity and dose constraints. To evaluate the toxicity and efficacy of combined radiation treatment with intensity-modulated radiation therapy (IMRT) and carbon ion boost, we conducted a prospective phase 2 IMRT-Heidelberg Ion-Beam Therapy Sinonasal Tumors (HIT-SNT) trial.
    Methods and materials: Between 2011 and 2019, we treated 35 patients with histologically proven, incompletely resected or inoperable adeno- (51%) or squamous cell carcinoma (49%) of the paranasal sinuses with combined IMRT (50 Gy) and carbon ion boost (24 Gy relative biologic effectiveness) to a total dose of 74 Gy.
    Results: Acute mucositis Common Terminology Criteria for Adverse Events (CTCAE) grade 3 occurred in 12% of patients (n = 4) and was accompanied by odynophagia CTCAE grade 3. Except for 1 case of grade 3 weight loss, no other acute high-grade toxicity (grade 3-4) was observed. In a small patient cohort of 15 patients eligible for long-term follow-up we have seen no high-grade (grade ≥3) long-term side effects 2 years after radiation therapy. None of these patients suffered from therapy-associated vision or hearing loss. Secondary endpoints were 2-year overall survival, 2-year local progression-free survival, 2-year progression-free survival, and 2-year metastases-free survival with 79.4%, 61.8%, 61.8%, and 64.8%, respectively.
    Conclusions: To our knowledge, this is the first prospective data on toxicity and outcome of bimodal radiation therapy for the rare entity of sinonasal malignancies. Our study shows a low rate of CTCAE-reported acute toxicity with reasonable tumor control and survival rates after bimodal radiation therapy, which therefore remains a therapy approach to be further evaluated.
    MeSH term(s) Humans ; Prospective Studies ; Heavy Ion Radiotherapy/adverse effects ; Radiotherapy, Intensity-Modulated/adverse effects ; Radiotherapy, Intensity-Modulated/methods ; Carbon ; Carcinoma, Squamous Cell/radiotherapy
    Chemical Substances Carbon (7440-44-0)
    Language English
    Publishing date 2023-10-20
    Publishing country United States
    Document type Clinical Trial, Phase II ; Journal Article
    ZDB-ID 197614-x
    ISSN 1879-355X ; 0360-3016
    ISSN (online) 1879-355X
    ISSN 0360-3016
    DOI 10.1016/j.ijrobp.2023.09.037
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  5. Article ; Online: Glioblastoma radiotherapy using Intensity modulated Radiotherapy (IMRT) or proton Radiotherapy-GRIPS Trial (Glioblastoma Radiotherapy via IMRT or Proton BeamS): a study protocol for a multicenter, prospective, open-label, randomized, two-arm, phase III study.

    König, Laila / Jäkel, Cornelia / von Knebel Doeberitz, Nikolaus / Kieser, Meinhard / Eberle, Fabian / Münter, Marc / Debus, Jürgen / Herfarth, Klaus

    Radiation oncology (London, England)

    2021  Volume 16, Issue 1, Page(s) 240

    Abstract: Background: Radiation therapy is an integral part of the multimodal primary therapy of glioblastomas. As the overall prognosis in this tumor entity remains unfavorable, current research is focused on additional drug therapies, which are often ... ...

    Abstract Background: Radiation therapy is an integral part of the multimodal primary therapy of glioblastomas. As the overall prognosis in this tumor entity remains unfavorable, current research is focused on additional drug therapies, which are often accompanied by increases in toxicity. By using proton beams instead of photon beams, it is possible to protect large parts of the brain which are not affected by the tumor more effectively. An initial retrospective matched-pair analysis showed that this theoretical physical benefit is also clinically associated with a reduction in toxicity during therapy and in the first few months thereafter.
    Methods/design: The GRIPS trial is a multicenter, prospective, open-label, randomized, two-arm, phase III study using either intensity modulated photon radiation techniques (standard arm) or proton beam radiotherapy (experimental arm). Additionally, patients are stratified according to "fractionation scheme" (normofractionated/hypofractionated), "subventricular zone involvement" (yes/no) and concurrent chemotherapy (yes/no) and the planned case number is 326 patients. Radiation therapy is performed with a dose of 30 × 2 Gy(RBE) or 33 × 1.8 Gy(RBE), or for patients treated according to the hypofractionation protocol with 15 × 2.67 Gy(RBE). A possible administration of additional chemotherapy (concurrent or adjuvant) or tumor treating fields is applied in dosage and frequency according to the therapy standard outside of this study. The primary endpoint is the cumulative rate of toxicity CTC grade 2 and higher in the first 4 months. Secondary endpoints include overall survival, progression-free survival, quality of life, and neurocognition.
    Discussion: Aim of the GRIPS study is to prospectively assess whether the theoretical physical advantage of proton beam radiotherapy will translate into a clinical reduction of toxicity during and in the first months after therapy. Trial registration ClinicalTrials (NCT): NCT04752280.
    MeSH term(s) Humans ; Brain Neoplasms/mortality ; Brain Neoplasms/radiotherapy ; Glioblastoma/mortality ; Glioblastoma/radiotherapy ; Prospective Studies ; Proton Therapy/methods ; Radiotherapy Dosage ; Radiotherapy, Intensity-Modulated/methods ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic ; Clinical Trials, Phase III as Topic
    Language English
    Publishing date 2021-12-20
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article
    ZDB-ID 2224965-5
    ISSN 1748-717X ; 1748-717X
    ISSN (online) 1748-717X
    ISSN 1748-717X
    DOI 10.1186/s13014-021-01962-8
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  6. Article ; Online: Which Patients With Rhabdomyosarcoma Need Radiotherapy? Analysis of the Radiotherapy Strategies of the CWS-96 and CWS-2002P Studies and SoTiSaR Registry.

    Koscielniak, Ewa / Timmermann, Beate / Münter, Marc / Weclawek-Tompol, Jadwiga / Ladenstein, Ruth / Niggli, Felix / Ljungman, Gustaf / Brecht, Ines B / Blank, Bernd / Hallmen, Erika / Scheer, Monika / Fuchs, Joerg / Seitz, Guido / Blattmann, Claudia / Sparber-Sauer, Monika / Klingebiel, Thomas

    Journal of clinical oncology : official journal of the American Society of Clinical Oncology

    2023  Volume 41, Issue 31, Page(s) 4916–4926

    Abstract: Purpose: To analyze and compare the indications, doses, and application methods of radiotherapy (RT) and their influence on prognosis of patients with localized rhabdomyosarcoma (RMS).: Methods: One thousand four hundred seventy patients with ... ...

    Abstract Purpose: To analyze and compare the indications, doses, and application methods of radiotherapy (RT) and their influence on prognosis of patients with localized rhabdomyosarcoma (RMS).
    Methods: One thousand four hundred seventy patients with localized RMS 21 years and younger entered on CWS-96, CWS-2002P, and SoTiSaR were eligible for the analysis. The median follow-up was 6.5 years (IQR, 3.3-9.5).
    Results: The 5-year event-free survival (EFS) and local control survival (LCS) for 910 (62%) irradiated versus nonirradiated patients were 71% versus 69% and 78% versus 73% (
    Conclusion: RT can be omitted in patients with IRS I eRMS. RT improves LCS and EFS in IRS II and III. RT improves OS in patients with HN-PM, with proton RT comparable with photon RT. Doses of 32 Gy (HART) or 36 and 41.4 Gy (CFRT) had comparable efficacy in patients with favorable risk profiles and 44.8 Gy (HART) or 50.4 and 55.8 Gy (CFRT) in the unfavorable groups.
    MeSH term(s) Humans ; Protons ; Rhabdomyosarcoma/drug therapy ; Prognosis ; Rhabdomyosarcoma, Embryonal/radiotherapy ; Progression-Free Survival ; Combined Modality Therapy ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use
    Chemical Substances Protons
    Language English
    Publishing date 2023-09-19
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 604914-x
    ISSN 1527-7755 ; 0732-183X
    ISSN (online) 1527-7755
    ISSN 0732-183X
    DOI 10.1200/JCO.22.02673
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    Zs.A 1847: Show issues Location:
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    Zs.MO 650: Show issues

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  7. Article ; Online: Second-line treatment of pediatric patients with relapsed rhabdomyosarcoma adapted to initial risk stratification: Data of the European Soft Tissue Sarcoma Registry (SoTiSaR).

    Heinz, Amadeus T / Ebinger, Martin / Schönstein, Anton / Fuchs, Jörg / Timmermann, Beate / Seitz, Guido / Vokuhl, Christian / Münter, Marc W / Pajtler, Kristian W / Stegmaier, Sabine / von Kalle, Thekla / Kratz, Christian P / Rößler, Jochen / Ljungman, Gustaf / Klingebiel, Thomas / Koscielniak, Ewa / Sparber-Sauer, Monika

    Pediatric blood & cancer

    2023  Volume 70, Issue 7, Page(s) e30363

    Abstract: Background: Outcome of relapsed disease of localized rhabdomyosarcoma remains poor. An individual treatment approach considering the initial systemic treatment and risk group was included in the Cooperative Weichteilsarkom Studiengruppe (CWS) Guidance.!# ...

    Abstract Background: Outcome of relapsed disease of localized rhabdomyosarcoma remains poor. An individual treatment approach considering the initial systemic treatment and risk group was included in the Cooperative Weichteilsarkom Studiengruppe (CWS) Guidance.
    Methods: Second-line chemotherapy (sCHT) ACCTTIVE based on anthracyclines (adriamycin, carboplatin, cyclophosphamide, topotecan, vincristine, etoposide) was recommended for patients with initial low- (LR), standard- (SR), and high-risk (HR) group after initial treatment without anthracyclines. TECC (topotecan, etoposide, carboplatin, cyclophosphamide) was recommended after initial anthracycline-based regimen in the very high-risk (VHR) group. Data of patients with relapse (n = 68) registered in the European Soft Tissue Sarcoma Registry SoTiSaR (2009-2018) were retrospectively analyzed.
    Results: Patients of initial LR (n = 2), SR (n = 16), HR (n = 41), and VHR (n = 9) group relapsed. sCHT consisted of ACCTTIVE (n = 36), TECC (n = 12), or other (n = 15). Resection was performed in 40/68 (59%) patients and/or radiotherapy in 47/68 (69%). Initial risk stratification, pattern/time to relapse, and achievement of second complete remission were significant prognostic factors. Microscopically incomplete resection with additional radiotherapy was not inferior to microscopically complete resection (p = .17). The 5-year event-free survival (EFS) and overall survival (OS) were 26% (±12%) and 31% (±14%). The 5-year OS of patients with relapse of SR, HR, and VHR groups was 80% (±21%), 20% (±16%), and 13% (±23%, p = .008), respectively.
    Conclusion: Adapted systemic treatment of relapsed disease considering the initial risk group and initial treatment is reasonable. New treatment options are needed for patients of initial HR and VHR groups.
    MeSH term(s) Humans ; Child ; Etoposide ; Carboplatin ; Retrospective Studies ; Topotecan ; Rhabdomyosarcoma ; Sarcoma ; Soft Tissue Neoplasms ; Cyclophosphamide ; Chronic Disease ; Anthracyclines ; Polyketides ; Recurrence ; Antineoplastic Combined Chemotherapy Protocols
    Chemical Substances Etoposide (6PLQ3CP4P3) ; Carboplatin (BG3F62OND5) ; Topotecan (7M7YKX2N15) ; Cyclophosphamide (8N3DW7272P) ; Anthracyclines ; Polyketides
    Language English
    Publishing date 2023-04-17
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2131448-2
    ISSN 1545-5017 ; 1545-5009
    ISSN (online) 1545-5017
    ISSN 1545-5009
    DOI 10.1002/pbc.30363
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    Zs.A 1131: Show issues Location:
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  8. Article ; Online: Significance of fusion status, Oberlin risk factors, local and maintenance treatment in pediatric and adolescent patients with metastatic rhabdomyosarcoma: Data of the European Soft Tissue Sarcoma Registry SoTiSaR.

    Heinz, Amadeus T / Schönstein, Anton / Ebinger, Martin / Fuchs, Jörg / Timmermann, Beate / Seitz, Guido / Vokuhl, Christian / Münter, Marc / Pajtler, Kristian W / Stegmaier, Sabine / von Kalle, Thekla / Kratz, Christian P / Ljungman, Gustaf / Juntti, Hanna / Klingebiel, Thomas / Koscielniak, Ewa / Sparber-Sauer, Monika

    Pediatric blood & cancer

    2023  Volume 71, Issue 1, Page(s) e30707

    Abstract: Background: Outcome of primary metastatic rhabdomyosarcoma (RMS) is poor. Certain risk factors as fusion status, Oberlin score, and local treatment of primary tumor are known to influence prognosis.: Procedure: Patients with metastatic RMS were ... ...

    Abstract Background: Outcome of primary metastatic rhabdomyosarcoma (RMS) is poor. Certain risk factors as fusion status, Oberlin score, and local treatment of primary tumor are known to influence prognosis.
    Procedure: Patients with metastatic RMS were treated according to Cooperative Weichteilsarkom Studiengruppe (CWS) guidance with chemotherapy (CHT), radiotherapy (RT) excluding total lung irradiation (TLI), complete resection of the primary tumor, and metastasectomy if possible. Kaplan-Meier estimators and Cox proportional hazard models were used to examine event-free survival (EFS) and overall survival (OS) involving also landmark analyses.
    Results: In the European Soft Tissue Sarcoma Registry SoTiSaR (2009-2018), 211 patients were analyzed. Many patients had fusion-positive alveolar RMS (n = 83; 39%). Median age was 9.4 years [0.1-19.7 years]. Treatment primarily consisted of CHT with CEVAIE (carboplatin, epirubicine, vincristine, actinomycin-D, ifosfamide, etoposide: 86%, other regimens: 14%), RT (71%), resection of primary tumor (37%), metastasectomy (19%), and lymph node sampling/dissection (21%). Maintenance treatment (MT) (oral trofosfamide, idarubicin, etoposide) was added in 74% of patients. Oberlin factors, fusion status, and MT were predictive for EFS and OS. MT with O-TIE was not improving outcome when adjusting for the immortal time bias. Local treatment of the primary tumor and radical irradiation (except TLI) improved EFS, not OS, when adjusting for the Oberlin score. Patients with fusion-negative alveolar RMS (n = 9) had an excellent outcome with a 5-year EFS and OS of 100%, compared to patients with embryonal RMS (49%/62%), PAX7- (22%/47%) and PAX3/FOXO1-positive ARMS (10/13%), respectively (p < .001).
    Conclusions: Prognosis of metastatic RMS primarily depends on fusion status and Oberlin score. Fusion status needs to be considered in future trials to optimize treatment outcome. The role of radical irradiation needs further investigation.
    MeSH term(s) Child ; Humans ; Adolescent ; Etoposide ; Rhabdomyosarcoma/pathology ; Sarcoma/drug therapy ; Risk Factors ; Rhabdomyosarcoma, Alveolar/pathology ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Soft Tissue Neoplasms/drug therapy ; Registries
    Chemical Substances Etoposide (6PLQ3CP4P3)
    Language English
    Publishing date 2023-10-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2131448-2
    ISSN 1545-5017 ; 1545-5009
    ISSN (online) 1545-5017
    ISSN 1545-5009
    DOI 10.1002/pbc.30707
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  9. Article ; Online: Radiotherapy and long-term sequelae in pediatric patients with parameningeal rhabdomyosarcoma: Results of two Cooperative Weichteilsarkom Studiengruppe (CWS) trials and one registry.

    Sparber-Sauer, Monika / Dietzschold, Maximilian / Schönstein, Anton / Heinz, Amadeus / Vokuhl, Christian / Pajtler, Kristian W / Harrabi, Semi / Lin, Yi-Lan / Kalle, Thekla von / Hagen, Rudolf / Ladenstein, Ruth / Kazanowska, Bernarda / Ljungman, Gustaf / Klingebiel, Thomas / Ebinger, Martin / Koscielniak, Ewa / Münter, Marc / Timmermann, Beate

    Pediatric blood & cancer

    2023  Volume 71, Issue 1, Page(s) e30742

    Abstract: Background: Parameningeal location of rhabdomyosarcoma (PM RMS) is known to be an unfavorable prognostic factor. Scarce data are available on radiotherapy (RT) concepts with regard to outcome.: Methods: Treatment and outcome of 395 children with PM ... ...

    Abstract Background: Parameningeal location of rhabdomyosarcoma (PM RMS) is known to be an unfavorable prognostic factor. Scarce data are available on radiotherapy (RT) concepts with regard to outcome.
    Methods: Treatment and outcome of 395 children with PM RMS registered within two Cooperative Weichteilsarkom Studiengruppe (CWS) trials and one registry (1995-2021) were evaluated.
    Results: Patients were IRS group II (n = 15) and III (n = 380) and received systemic treatment according to the enrolled protocols: I2VA (n = 172), VAIA/CEVAIE (n = 223). Delayed resection was performed in 88/395 (22%) patients, and RT was additionally given in 79/88 (90%) resected patients. RT was the predominant local treatment in 355/395 (90%) patients: hyperfractionated accelerated photon (HART; n = 77), conventionally fractionated photon (n = 91) or proton beam (n = 126), brachytherapy (n = 4), heavy ions (n = 1), not available (n = 56). In the subgroup of RT as only local treatment (n = 278), no intracranial tumor extension and complete remission at end of treatment were significant positive prognostic factors. No significant difference on tumor outcome was seen between different radiotherapy concepts. Long-term toxicity with mostly endocrinological and visual deficiencies was reported in 161/279 (58%) surviving patients with a lower trend after proton beam RT (48%) when compared to HART or conventionally fractionated photon RT (71% and 72%, respectively). Ten-year event-free and overall survival in the overall group were 62% (±5, 95% confidence interval [CI]) and 67% (±5, 95% CI); in the RT-only group 67% (±6, 95% CI) and 71% (±6, 95% CI), respectively.
    Conclusion: CWS data confirm the recent RT concept in PM RMS. Long-term sequelae as endocrinological and visual deficiencies need to be addressed.
    MeSH term(s) Child ; Humans ; Infant ; Protons ; Rhabdomyosarcoma/radiotherapy ; Rhabdomyosarcoma/drug therapy ; Combined Modality Therapy ; Remission Induction ; Disease Progression ; Registries ; Antineoplastic Combined Chemotherapy Protocols
    Chemical Substances Protons
    Language English
    Publishing date 2023-10-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2131448-2
    ISSN 1545-5017 ; 1545-5009
    ISSN (online) 1545-5017
    ISSN 1545-5009
    DOI 10.1002/pbc.30742
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  10. Article ; Online: Pre-operative radiotherapy is associated with superior local relapse-free survival in advanced synovial sarcoma.

    Scheer, Monika / Hallmen, Erika / Vokuhl, Christian / Fuchs, Jörg / Tunn, Per-Ulf / Münter, Marc / Timmermann, Beate / Bauer, Sebastian / Henssen, Anton George / Kazanowska, Bernarda / Niggli, Felix / Ladenstein, Ruth / Ljungman, Gustaf / Eggert, Angelika / Klingebiel, Thomas / Koscielniak, Ewa

    Journal of cancer research and clinical oncology

    2022  Volume 149, Issue 5, Page(s) 1717–1731

    Abstract: Purpose: Optimization of local therapies in synovial sarcoma (SS) considered unresectable at diagnosis is needed. We evaluated the effects of neoadjuvant versus adjuvant radiation versus surgery only on long-term outcomes.: Methods: Patients with ... ...

    Abstract Purpose: Optimization of local therapies in synovial sarcoma (SS) considered unresectable at diagnosis is needed. We evaluated the effects of neoadjuvant versus adjuvant radiation versus surgery only on long-term outcomes.
    Methods: Patients with macroscopic SS tumors before chemotherapy (IRS-group-III) in the trials CWS-81, CWS-86, CWS-91, CWS-96, CWS-2002-P and SoTiSaR-registry were analyzed. Local therapies were scheduled after 3 neoadjuvant chemotherapy cycles.
    Results: Median age of 145 patients was 14.5 years. 106 survivors had median follow-up of 7.0 years. Tumor site was 96 extremities, 19 head-neck, 16 shoulder/hip, 14 trunk. Tumors were < 3 cm in 16, 3-5 cm in 28, 5-10 cm in 55, > 10 cm in 34 patients. In a secondary resection during chemotherapy, R0-status was accomplished in 82, R1 in 30, R2 in 21 (12 missing). Radiotherapy was administered to 115 (R0 61, R1 29, R2 20, missing 5), thereof 57 before and 52 after tumor resection. 23 were treated with surgery only. For all patients, 5 year event-free (EFS) and overall survival (OS) was 68.9% ± 7.6 (95%CI) and 79.1% ± 6.9. To establish independent significance, tumor site, size, surgical results and sequencing of local therapies were analyzed in a Cox regression analysis. Variables associated with EFS and OS are site, size and sequencing of local therapies. Variables associated with local recurrence are site, surgical results and sequencing of local therapies. The only variable associated with suffering metastatic recurrence is tumor size.
    Conclusion: Differences in sequencing of local therapy procedures are independently associated with outcomes. Best local control is achieved when tumors are irradiated pre-operatively and undergo R0 or R1 resection thereafter.
    MeSH term(s) Humans ; Adolescent ; Sarcoma, Synovial/radiotherapy ; Neoplasm Recurrence, Local/pathology ; Follow-Up Studies ; Combined Modality Therapy ; Radiotherapy, Adjuvant ; Chronic Disease ; Retrospective Studies
    Language English
    Publishing date 2022-06-10
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 134792-5
    ISSN 1432-1335 ; 0171-5216 ; 0084-5353 ; 0943-9382
    ISSN (online) 1432-1335
    ISSN 0171-5216 ; 0084-5353 ; 0943-9382
    DOI 10.1007/s00432-022-04051-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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