Publications by authors named "Borm K"
Purpose: The aim of this review is to give an overview of the results of prospective and retrospective studies using allogenic reconstruction and postmastectomy radiotherapy (PMRT) in breast cancer and to make recommendations regarding this interdisciplinary approach.
Materials And Methods: A PubMed search was conducted to extract relevant articles from 2000 to 2024. The search was performed using the following terms: (breast cancer) AND (reconstruction OR implant OR expander) AND (radiotherapy OR radiation).
Background: Post-Therapy-Pneumonitis (PTP) is a critical side effect of both, thoracic radio(chemo)therapy (R(C)T) and immune checkpoint inhibition (ICI). However, disease characteristics and patient-specific risk factors of PTP after combined R(C)T + ICI are less understood. Given that RT-triggered PTP is strongly dependent on the volume and dose of RT [1], driven by inflammatory mechanisms, we hypothesize that combination therapy of R(C)T with ICI influences the dose-volume-effect correlation for PTP.
View Article and Find Full Text PDFPurpose: Rapidly expanding medical literature challenges oncologists seeking targeted cancer therapies. General-purpose large language models (LLMs) lack domain-specific knowledge, limiting their clinical utility. This study introduces the LLM system Medical Evidence Retrieval and Data Integration for Tailored Healthcare (MEREDITH), designed to support treatment recommendations in precision oncology.
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- Randomized studies suggest that (ultra-)hypofractionation is just as effective as a traditional 5-week radiation schedule for treating postoperative breast cancer, but there's limited data on its long-term impact on secondary cancers.
- A study involving 20 breast cancer patients examined different radiation schedules and found that (ultra-)hypofractionation significantly reduced the risk of secondary malignancies like lung cancer, contralateral breast cancer, and soft tissue sarcoma.
- The results indicated that using (ultra-)hypofractionation could lower the risk of developing secondary malignancies more than conventional scheduling, with varying effects based on the radiation technique (3D-CRT vs. VMAT).
Article Synopsis
- Skin inflammation and conditions like moist epitheliolysis and edema are common acute side effects of breast radiotherapy (RT).
- The study aimed to evaluate the effectiveness of tissue-derived radiomics features compared to total breast volume (TBV) in predicting these side effects.
- The best predictive model used a LASSO classifier based on TBV, achieving an AUROC of 0.74, similar to the AUROC of 0.75 for TBV alone, with mammary tissue showing greater predictive power than glandular tissue.
Article Synopsis
- The study investigates the lymphatic drainage to contralateral internal mammary nodes (cIMN) in breast cancer patients and highlights its neglect in current adjuvant radiotherapy practices.* -
- It analyzes the incidental radiation dose to cIMN in 120 advanced treatment plans, noting that higher doses are observed when including internal mammary node irradiation (IMNI) and during free breathing compared to deep inspiration breath hold (DIBH).* -
- The findings indicate that cIMN receives low radiation doses in existing randomized trials and treatment methods, prompting the need for further research on the effects of targeting cIMN in high-risk breast cancer patients.*
Article Synopsis
- A significant percentage (25-50%) of patients receiving radiotherapy experience anxiety and psychological distress, impacting their quality of life and treatment outcomes, highlighting the need for better patient-centered care.
- A survey conducted with 100 radiotherapy patients revealed that while 78% wanted to be actively involved in their treatment, only 27% had previously practiced relaxation exercises, indicating a gap in current patient engagement.
- The majority (56.4%) of participants showed interest in learning relaxation techniques to manage stress during treatment, emphasizing the importance of developing targeted relaxation programs for radiotherapy patients.
Article Synopsis
- Metastasis-directed therapy has potential benefits for patients with oligometastatic disease (OMD), but breast cancer studies have not yet confirmed these benefits through randomized trials.
- A study at the Technical University of Munich analyzed 80 patients using F-FDG PET/CT images to better define OMD, revealing that nearly half the time, this imaging method significantly changed the assessment of metastatic disease compared to conventional CT.
- F-FDG PET/CT discovered additional metastases in a third of cases, highlighting the need for clearer standards in imaging definitions for future research and clinical practices in breast cancer treatment.
Article Synopsis
- The review aimed to assess the effectiveness of radiotherapy in managing brain metastases and leptomeningeal carcinomatosis in breast cancer patients and to provide treatment recommendations based on existing literature.
- A comprehensive search was conducted through PubMed for studies published between 1985 and May 2023, focusing on various types of radiotherapy for breast cancer-related brain metastases.
- Conclusions indicate that while specific radiotherapy guidelines show variability based on breast cancer subtypes, stereotactic radiosurgery is generally recommended for 1-4 brain metastases, while whole-brain radiotherapy is advised for multiple cases, especially in symptomatic patients, although treatment plans should be tailored and may include reevaluating local options after several weeks.
Article Synopsis
- The study focuses on the importance of identifying internal mammary lymph node (IMN) metastases in breast cancer patients to optimize treatment strategies like regional lymph node irradiation.
- Researchers analyzed a total of 297 patients with breast cancer who showed evidence of IMN and/or axillary metastases, assessing tumor contact with internal mammary perforating vessels (IMPV) using advanced MRI techniques.
- Results indicated a strong correlation between major IMPV contact and the presence of gross IMN involvement, with the predictive accuracy of major IMPV contact surpassing traditional clinical models, suggesting it could be a key risk factor in determining treatment plans.
Article Synopsis
- The study investigates how variations in the skin microbiome can affect the severity of radiation dermatitis in breast cancer patients receiving adjuvant radiotherapy.
- The research involved 20 women who underwent a comprehensive analysis of their skin microbiome before, during, and after a 7-week radiotherapy treatment.
- Findings indicated that low levels of certain healthy skin bacteria at the start of treatment were linked to more severe dermatitis, highlighting the potential role of the microbiome in skin reactions to radiation therapy.
Patients suffering from painful spinal bone metastases (PSBMs) often undergo palliative radiation therapy (RT), with an efficacy of approximately two thirds of patients. In this exploratory investigation, we assessed the effectiveness of machine learning (ML) models trained on radiomics, semantic and clinical features to estimate complete pain response. Gross tumour volumes (GTV) and clinical target volumes (CTV) of 261 PSBMs were segmented on planning computed tomography (CT) scans.
View Article and Find Full Text PDFThe purpose of this study was to investigate the impact of deep inspiration breath hold (DIBH) on the positioning of thoracic structures and provide treatment planning recommendations for internal mammary chain (IMC) irradiation in breast cancer patients. Thirty-two breast cancer patients from our database underwent both DIBH and free breathing (FB) treatment planning. Contouring of the axillary lymph node clinical target volumes (CTVs: level I, II, III, IV, and IMC according to ESTRO), the internal mammary artery (IMA), the heart, and the left anterior descending artery (LAD) was performed.
View Article and Find Full Text PDFBackground And Purpose: In breast cancer patients, the increasing de-escalation of axillary surgery and the improving resolution of diagnostic imaging results in a more frequent detection of residual, radiographically suspect lymph nodes (sLN) after surgery. If resection of the remaining suspect lymph nodes is not feasible, a simultaneous boost to the lymph node metastases (LN-SIB) can be applied. However, literature lacks data regarding the outcome and safety of this technique.
View Article and Find Full Text PDFBackground: Soft tissue sarcomas (STS) are a relatively rare group of malignant tumors. Currently, there is very little published clinical data, especially in the context of curative multimodal therapy with image-guided, conformal, intensity-modulated radiotherapy.
Methods: Patients who received preoperative or postoperative intensity-modulated radiotherapy for STS of the extremities or trunk with curative intent were included in this single centre retrospective analysis.
The extent of elective nodal irradiation (ENI) in patients undergoing definitive chemoradiotherapy (dCRT) for esophageal squamous cell carcinoma (ESCC) remains unclear. The aim of this dosimetric study was to evaluate the extent of incidental nodal irradiation using modern radiation techniques. A planning target volume (PTV) was generated for 30 patients with node-negative esophageal carcinoma (13 cervical/upper third, 7 middle third, 10 lower third/abdomen).
View Article and Find Full Text PDFWe compared our institutional experience with intensity-modulated radiotherapy (IMRT) and 3D-conformal radiotherapy (3D-RT) for definitive treatment of primary anal cancer. We performed a single-institution retrospective review of all patients with anal squamous cell carcinoma treated with definitive (chemo) radiotherapy with curative intent from 2004 through 2018. We assessed several prognostic factors in respect to relevant survival endpoints.
View Article and Find Full Text PDFBackground: Approximately 20-40% of patients with prostate cancer (PC) who undergo radical prostatectomy (RP) experience relapse, with the majority of these cases developing pelvic lymph node (LN) metastases. Taking new data from the prostate-specific membrane antigen (PSMA) positron emission tomography (PET) era into account, the Radiation Therapy Oncology Group (RTOG) 2009 contouring guideline for the pelvic LNs from 2009 was updated by the NRG Oncology group in 2020 (NRG 2020).
Objective: To evaluate and validate the updated NRG 2020 guideline with our established LN atlas.
The current study aims to assess the suitability of setup errors during the first three treatment fractions to determine cone-beam computed tomography (CBCT) frequency in adjuvant breast radiotherapy. For this, 45 breast cancer patients receiving non-hypofractionated radiotherapy after lumpectomy, including a simultaneous integrated boost (SIB) to the tumor bed and daily CBCT imaging, were retrospectively selected. In a first step, mean and maximum setup errors on treatment days 1-3 were correlated with the mean setup errors during subsequent treatment days.
View Article and Find Full Text PDFBackground: In the case of breast cancer (BC), radiotherapy (RT) helps reduce locoregional recurrence and BC-related deaths but can lead to cardiotoxicity, resulting in an increased risk of long-term major cardiovascular events. It is therefore of primary importance to early detect subclinical left ventricular (LV) dysfunction in BC patients after RT and to determine the dose-response relationships between cardiac doses and these events.
Methods: Within the frame of the MEDIRAD European project (2017-2022), the prospective multicenter EARLY-HEART study (ClinicalTrials.
Thoracic stereotactic body radiation therapy (SBRT) is extensively used in combination with immune checkpoint blockade (ICB). While current evidence suggests that the occurrence of pneumonitis as a side effect of both treatments is not enhanced for the combination, the dose-volume correlation remains unclear. We investigate dose-volume-effect correlations for pneumonitis after combined SBRT + ICB.
View Article and Find Full Text PDFAnal cancer and the related treatment are generally known to affect patients' quality of life. The aim of this study was to assess self-reported quality of life (QoL) of anal cancer patients after combined radiation and chemotherapy, and to identify patient-, disease-, and therapy-related factors associated with QoL. A total of 94 patients treated with definitive chemoradiation for anal cancer at our institution in the period from 2004 to 2018 were identified from our database.
View Article and Find Full Text PDFBackground: Current literature lacks a comparison of lymph node metastases and non-pathological lymph nodes distribution in breast cancer patients. The aim of the current retrospective study was to generate a comprehensive atlas of the lymph node system.
Methods: 143 breast cancer patients underwent F-18-FDG-PET/CT (PET/CT) imaging for staging purposes and were diagnosed with regional lymph node metastases.
Article Synopsis
- The study investigates whether hypofractionated radiotherapy (HF) results in lower rates of acute radiodermatitis than conventional normofractionated radiotherapy (CF) in breast cancer patients.
- A total of 166 patients were assessed before treatment, after treatment, and six weeks post-treatment using various scoring methods to evaluate skin reactions.
- Results indicate that the CF group experienced significantly more acute side effects at the end of treatment compared to the HF group, supporting the idea that HF may be a better option for minimizing acute skin damage in breast cancer radiotherapy.