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  1. Article ; Online: Comparison of cisplatin and mitomycin C/5-FU as radiosensitisers in the treatment of locally advanced vulvar cancer: results of a retrospective, observational, single-institutional cohort study

    Linz, Valerie Catherine / Schwanbeck, Carina / Krajnak, Slavomir / Anic, Katharina / Jäkel, Jörg / Schwab, Roxana / Schmidt, Marcus / Schmidberger, Heinz / Hasenburg, Annette / Battista, Marco Johannes

    J Cancer Res Clin Oncol. 2023 Apr., v. 149, no. 4 p.1391-1399

    2023  

    Abstract: PURPOSE: We retrospectively investigated the widely used radiosensitisers cisplatin and mitomycin C/5-fluorouracil (5-FU) in patients with locally advanced vulvar cancer for outcome and toxicity. METHODS: We screened the archive for patients treated with ...

    Abstract PURPOSE: We retrospectively investigated the widely used radiosensitisers cisplatin and mitomycin C/5-fluorouracil (5-FU) in patients with locally advanced vulvar cancer for outcome and toxicity. METHODS: We screened the archive for patients treated with chemoradiation for vulvar cancer diagnosed between 01/2010 and 08/2021 at our institution. The impact of both radiosensitisers on prognosis was compared using Kaplan–Meier method and Cox-regression analysis. RESULTS: One hundred and forty-three patients with vulvar cancer were screened. Twenty-nine patients received chemoradiation (mitomycin C/5-FU n = 14; cisplatin n = 12; others n = 3) as a primary, neoadjuvant or adjuvant treatment. Median follow-up was 15.5 months. Patients in the cisplatin group were older (mean age 54.4 vs. 70.7; p = 0.004). However, the mitomycin C/5-FU group had more advanced tumour stages. The 2-year recurrence-free survival (RFS) was comparable (44.5% vs. 33.3%; p = 0.932). The 2-year overall survival (OS) showed a numerical but not statistically significant difference in favour of the mitomycin C/5-FU group (59.7% vs. 31.7%; p = 0.37). 64.3% (9 out of 14) patients, who received mitomycin C/5-FU achieved clinical complete response (cCR) compared to 41.7% (5 out of 12) who received cisplatin (p = 0.505). Radiodermatitis was the most common adverse event in both groups (81%) and more severe in the mitomycin C/5-FU cohort. Myelotoxicity was frequently observed in both groups. Eighteen patients received an additional radiation boost with 10.0 (9–16) Gy and showed a significantly prolonged RFS (p = 0.027) and OS (p = 0.003). CONCLUSION: Mitomycin C/5-FU may be considered in the treatment of young and healthy patients with locally advanced vulvar cancer.
    Keywords adjuvants ; cisplatin ; cohort studies ; fluorouracil ; mitomycin ; neoplasms ; prognosis ; toxicity
    Language English
    Dates of publication 2023-04
    Size p. 1391-1399.
    Publishing place Springer Berlin Heidelberg
    Document type Article ; Online
    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/s00432-022-04006-0
    Database NAL-Catalogue (AGRICOLA)

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  2. Article ; Online: Radiation-induced DNA double-strand breaks in peripheral leukocytes and therapeutic response of heel spur patients treated by orthovoltage X-rays or a linear accelerator.

    Zahnreich, Sebastian / Rösler, Hans-Peter / Schwanbeck, Carina / Karle, Heiko / Schmidberger, Heinz

    Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al

    2020  Volume 196, Issue 12, Page(s) 1116–1127

    Abstract: Purpose: Biodosimetric assessment and comparison of radiation-induced deoxyribonucleic acid (DNA) double-strand breaks (DSBs) by γH2AX immunostaining in peripheral leukocytes of patients with painful heel spur after radiation therapy (RT) with ... ...

    Abstract Purpose: Biodosimetric assessment and comparison of radiation-induced deoxyribonucleic acid (DNA) double-strand breaks (DSBs) by γH2AX immunostaining in peripheral leukocytes of patients with painful heel spur after radiation therapy (RT) with orthovoltage X‑rays or a 6-MV linear accelerator (linac). The treatment response for each RT technique was monitored as a secondary endpoint.
    Patients and methods: 22 patients were treated either with 140-kV orthovoltage X‑rays (n = 11) or a 6-MV linac (n = 11) with two weekly fractions of 0.5 Gy for 3 weeks. In both scenarios, the dose was prescribed to the International Commission on Radiation Units and Measurements (ICRU) dose reference point. Blood samples were obtained before and 30 min after the first RT session. γH2AX foci were quantified by immunofluorescence microscopy to assess the yield of DSBs at the basal level and after radiation exposure ex vivo or in vivo. The treatment response was assessed before and 3 months after RT using a five-level functional calcaneodynia score.
    Results: RT for painful heel spurs induced a very mild but significant increase of γH2AX foci in patients' leukocytes. No difference between the RT techniques was observed. High and comparable therapeutic responses were documented for both treatment modalities. This trial was terminated preliminarily after an interim analysis (22 patients randomized).
    Conclusion: Low-dose RT for painful heel spurs with orthovoltage X‑rays or a 6-MV linac is an effective treatment option associated with a very low and comparable radiation burden to the patient, as confirmed by biodosimetric measurements.
    MeSH term(s) Adult ; Aged ; DNA Breaks, Double-Stranded/radiation effects ; Female ; Heel Spur/radiotherapy ; Histones/analysis ; Humans ; Leukocytes/radiation effects ; Male ; Middle Aged ; Particle Accelerators/instrumentation ; Radiotherapy/adverse effects ; Radiotherapy/instrumentation ; Radiotherapy Dosage
    Chemical Substances H2AX protein, human ; Histones
    Language English
    Publishing date 2020-07-10
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 84983-2
    ISSN 1439-099X ; 0179-7158 ; 0039-2073
    ISSN (online) 1439-099X
    ISSN 0179-7158 ; 0039-2073
    DOI 10.1007/s00066-020-01662-4
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    In stock of ZB MED Cologne/Königswinter

    Ue I Zs.40: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Comparison of cisplatin and mitomycin C/5-FU as radiosensitisers in the treatment of locally advanced vulvar cancer: results of a retrospective, observational, single-institutional cohort study.

    Linz, Valerie Catherine / Schwanbeck, Carina / Krajnak, Slavomir / Anic, Katharina / Jäkel, Jörg / Schwab, Roxana / Schmidt, Marcus / Schmidberger, Heinz / Hasenburg, Annette / Battista, Marco Johannes

    Journal of cancer research and clinical oncology

    2022  Volume 149, Issue 4, Page(s) 1391–1399

    Abstract: Purpose: We retrospectively investigated the widely used radiosensitisers cisplatin and mitomycin C/5-fluorouracil (5-FU) in patients with locally advanced vulvar cancer for outcome and toxicity.: Methods: We screened the archive for patients treated ...

    Abstract Purpose: We retrospectively investigated the widely used radiosensitisers cisplatin and mitomycin C/5-fluorouracil (5-FU) in patients with locally advanced vulvar cancer for outcome and toxicity.
    Methods: We screened the archive for patients treated with chemoradiation for vulvar cancer diagnosed between 01/2010 and 08/2021 at our institution. The impact of both radiosensitisers on prognosis was compared using Kaplan-Meier method and Cox-regression analysis.
    Results: One hundred and forty-three patients with vulvar cancer were screened. Twenty-nine patients received chemoradiation (mitomycin C/5-FU n = 14; cisplatin n = 12; others n = 3) as a primary, neoadjuvant or adjuvant treatment. Median follow-up was 15.5 months. Patients in the cisplatin group were older (mean age 54.4 vs. 70.7; p = 0.004). However, the mitomycin C/5-FU group had more advanced tumour stages. The 2-year recurrence-free survival (RFS) was comparable (44.5% vs. 33.3%; p = 0.932). The 2-year overall survival (OS) showed a numerical but not statistically significant difference in favour of the mitomycin C/5-FU group (59.7% vs. 31.7%; p = 0.37). 64.3% (9 out of 14) patients, who received mitomycin C/5-FU achieved clinical complete response (cCR) compared to 41.7% (5 out of 12) who received cisplatin (p = 0.505). Radiodermatitis was the most common adverse event in both groups (81%) and more severe in the mitomycin C/5-FU cohort. Myelotoxicity was frequently observed in both groups. Eighteen patients received an additional radiation boost with 10.0 (9-16) Gy and showed a significantly prolonged RFS (p = 0.027) and OS (p = 0.003).
    Conclusion: Mitomycin C/5-FU may be considered in the treatment of young and healthy patients with locally advanced vulvar cancer.
    MeSH term(s) Female ; Humans ; Middle Aged ; Cisplatin/adverse effects ; Mitomycin/adverse effects ; Retrospective Studies ; Fluorouracil/adverse effects ; Vulvar Neoplasms/drug therapy ; Vulvar Neoplasms/radiotherapy ; Vulvar Neoplasms/etiology ; Cohort Studies ; Antineoplastic Combined Chemotherapy Protocols/adverse effects
    Chemical Substances Cisplatin (Q20Q21Q62J) ; Mitomycin (50SG953SK6) ; Fluorouracil (U3P01618RT)
    Language English
    Publishing date 2022-04-22
    Publishing country Germany
    Document type Observational Study ; 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/s00432-022-04006-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Uh III Zs.10: Show issues Location:
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  4. Article ; Online: Adjuvant temozolomide-based chemoradiotherapy versus radiotherapy alone in patients with WHO III astrocytoma: The Mainz experience.

    Mayer, Arnulf / Schwanbeck, Carina / Sommer, Clemens / Stockinger, Marcus / Giese, Alf / Renovanz, Mirjam / Vaupel, Peter / Schmidberger, Heinz

    Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al

    2015  Volume 191, Issue 8, Page(s) 665–671

    Abstract: Background: It is currently unclear whether adjuvant therapy for WHO grade III anaplastic astrocytomas (AA) should be carried out as combined chemoradiotherapy with temozolomide (TMZ)--analogous to the approach for glioblastoma multiforme--or as ... ...

    Abstract Background: It is currently unclear whether adjuvant therapy for WHO grade III anaplastic astrocytomas (AA) should be carried out as combined chemoradiotherapy with temozolomide (TMZ)--analogous to the approach for glioblastoma multiforme--or as radiotherapy (RT) alone.
    Patients and methods: A retrospective analysis of data from 90 patients with AA, who were treated between November 1997 and February 2014. Assessment of overall (OS) and progression-free survival (PFS) was performed according to treatment categories: (1) 50%, RT + TMZ according to protocol, (2) 11%, RT + TMZ with dose reduction, (3) 26%, RT alone, and (4) 13%, individualized, primarily palliative therapy. No dose reduction was necessary in the RT alone group.
    Results: Median OS was 85, 69, and 43 months for treatment categories 1/2, 3, and 4, respectively. These differences were not statistically significant. PFS was 35, 29, 48, and 33 months for categories 1, 2, 3, and 4, respectively; again without significant differences between categories. In a subgroup of 39 patients with known IDH1 R132H status, the presence of this mutation correlated with significantly longer OS (p = 0.01) and PFS (p = 0.002). Complete or partial tumor resection and younger age also correlated with a significantly better prognosis, and this influence persisted in multivariate analysis. In the IDH1 R132H subgroup analysis, only this marker retained an independent prognostic value.
    Discussion and conclusion: A general superiority of combined chemoradiotherapy compared to RT alone could not be demonstrated. Biomarkers for predicting the benefits of combination therapy using RT and TMZ are needed for patients with AA.
    MeSH term(s) Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Astrocytoma/mortality ; Astrocytoma/pathology ; Astrocytoma/therapy ; Brain Neoplasms/mortality ; Brain Neoplasms/pathology ; Brain Neoplasms/therapy ; Chemoradiotherapy, Adjuvant ; Combined Modality Therapy ; Dacarbazine/administration & dosage ; Dacarbazine/adverse effects ; Dacarbazine/analogs & derivatives ; Disease-Free Survival ; Dose Fractionation ; Female ; Germany ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm, Residual/mortality ; Neoplasm, Residual/pathology ; Neoplasm, Residual/therapy ; Radiotherapy, Adjuvant ; Retrospective Studies
    Chemical Substances Dacarbazine (7GR28W0FJI) ; temozolomide (YF1K15M17Y)
    Language English
    Publishing date 2015-08
    Publishing country Germany
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 84983-2
    ISSN 1439-099X ; 0179-7158 ; 0039-2073
    ISSN (online) 1439-099X
    ISSN 0179-7158 ; 0039-2073
    DOI 10.1007/s00066-015-0855-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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