Publications by authors named "David Krug"

Metastasis-directed therapy (MDT) for oligometastatic breast cancer (≤ 5 metastases) has shown little effect in specific scenarios of randomized trials. Therefore, we aimed to assess outcomes after metastasis-directed stereotactic radiotherapy (SRT) in various clinical scenarios. We conducted an international retrospective cohort study in thirteen centers including breast cancer patients receiving SRT to any metastatic site.

View Article and Find Full Text PDF

Background: Whether surgical axillary staging as part of breast-conserving therapy can be omitted without compromising survival has remained unclear.

Methods: In this prospective, randomized, noninferiority trial, we investigated the omission of axillary surgery as compared with sentinel-lymph-node biopsy in patients with clinically node-negative invasive breast cancer staged as T1 or T2 (tumor size, ≤5 cm) who were scheduled to undergo breast-conserving surgery. We report here the per-protocol analysis of invasive disease-free survival (the primary efficacy outcome).

View Article and Find Full Text PDF
Article Synopsis
  • - The study focuses on Stereotactic Arrhythmia Radioablation (STAR) as a treatment for ventricular tachycardia (VT), especially when traditional catheter-based methods are not viable, emphasizing the challenges in accurately defining treatment targets based on electro-anatomic maps (EAM).
  • - Two different software solutions were evaluated for their effectiveness in transferring 2D target data from EAM into 3D CT volume coordinates, with a cross-validation study conducted on data from ten patients.
  • - Results showed that the target volumes and surface areas obtained from both methods were nearly identical, suggesting that both software solutions are reliable for ensuring quality assurance and enhancing treatment accuracy in STAR procedures.
View Article and Find Full Text PDF

Purpose: STereotactic Arrhythmia Radioablation (STAR) showed promising results in patients with refractory ventricular tachycardia. However, clinical data are scarce and heterogeneous. The STOPSTORM.

View Article and Find Full Text PDF

The Breast Committee of the Arbeitsgemeinschaft Gynäkologische Onkologie (German Gynecological Oncology Group, AGO) presents the 2024 update of the evidence-based recommendations for the diagnosis and treatment of patients with locally advanced and metastatic breast cancer.

View Article and Find Full Text PDF

Introduction: Each year the interdisciplinary AGO (Arbeitsgemeinschaft Gynäkologische Onkologie, German Gynecological Oncology Group) Breast Committee on Diagnosis and Treatment of Breast Cancer provides updated state-of-the-art recommendations for early and metastatic breast cancer.

Methods: The updated evidence-based treatment recommendations for early and metastatic breast cancer have been released in March 2024.

Results And Conclusion: This paper concisely captures the updated recommendations for early breast cancer chapter by chapter.

View Article and Find Full Text PDF
Article Synopsis
  • - The interpretation of clinical evidence varies based on clinical studies and personal experiences, highlighting the significance of expert panels like the Advanced Breast Cancer Panel (ABC7), which met in November 2023.
  • - The 2023 conference addressed advanced breast cancer, revealing clear answers regarding the use of CDK4/6 inhibitors and the potential role of chemotherapy based on extensive new data.
  • - Key discussions included therapeutic approaches for patients with complex conditions such as brain metastases and older patients, emphasizing the need for tailored treatments across various cancer subtypes.
View Article and Find Full Text PDF

Sacituzumab govitecan (SG) is a new treatment option for patients with metastatic triple-negative and hormone receptor-positive, HER2-negative breast cancer. This antibody-drug conjugate is currently approved as monotherapy. Palliative radiotherapy is frequently used to treat symptomatic metastases locally.

View Article and Find Full Text PDF

Brainstem metastases (BSM) present a significant neuro-oncological challenge, resulting in profound neurological deficits and poor survival outcomes. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) offer promising therapeutic avenues for BSM despite their precarious location. This international multicenter study investigates the efficacy and safety of SRS and FSRT in 136 patients with 144 BSM treated at nine institutions from 2005 to 2022.

View Article and Find Full Text PDF

Total neoadjuvant therapy (TNT) is an evolving treatment schedule for locally advanced rectal cancer (LARC), allowing for organ preservation in a relevant number of patients in the case of complete response. Patients who undergo this so-called "watch and wait" approach are likely to benefit regarding their quality of life (QoL), especially if definitive ostomy could be avoided. In this work, we performed the first cost-effectiveness analysis from the patient perspective to compare costs for TNT with radical resection after neoadjuvant chemoradiation (CRT) in the German health care system.

View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF

Background: Neoadjuvant chemotherapy (NACT) is routinely used for patients with triple-negative breast cancer (TNBC). Upfront breast-conserving therapy (BCT) consisting of breast-conserving surgery (BCS) and adjuvant radiotherapy (RT) has been shown to be associated with improved outcome in patients with early TNBC as compared to mastectomy.

Methods: We identified 2632 patients with early TNBC from the German Breast Group meta-database.

View Article and Find Full Text PDF

Purpose: To summarize the radiotherapy-relevant statements of the 18th St. Gallen Breast Cancer Consensus Conference and interpret the findings in light of German guideline recommendations.

Methods: Statements and voting results from the 18th St.

View Article and Find Full Text PDF

In situ transmission electron microscopy (TEM) observations of the metal-organic vapor phase epitaxy (MOVPE) growth promise to enhance the understanding of this complex process. However, a new experimental approach is required, capable of live imaging at the atomic scale and simultaneously reflecting this method's elevated pressures. To this end, a closed gas cell in situ TEM setup is used as a micrometer-scaled MOVPE reactor to grow GaP using tertiary butyl phosphine (TBP) and trimethyl gallium (TMGa).

View Article and Find Full Text PDF

Background: The past 3 decades have seen an unprecedented shift toward treatment de-escalation in surgical therapy of breast cancer.

Summary: Radical mastectomy has been replaced by breast-conserving and oncoplastic approaches in most patients, and full axillary lymph node dissection by less radical staging procedures, such as sentinel lymph node biopsy and targeted axillary dissection. Further, attempts have been made to spare healthy tissue while increasing the probability of removing the tumor with clear margins, thus improving cosmetic results and minimizing the risk of local recurrence.

View Article and Find Full Text PDF

Background: Radiation dermatitis (RD) remains the most common side effect in radiation therapy (RT) with various pharmaceutical options available for prevention and treatment. We sought to determine pharmaceutical management patterns of radiation dermatitis among radiation oncology professionals.

Methods: We conducted a survey on RD among the German-speaking community of radiation oncologists inquiring for their opinion on preventive and therapeutic pharmaceutical approaches for acute RD.

View Article and Find Full Text PDF

Purpose: Patient satisfaction with healthcare has been linked to clinical outcomes and regulatory agencies demand its regular assessment. Therefore, we aimed to investigate patient satisfaction with radiotherapy care and its determinants.

Methods: This is a secondary analysis of a multicenter prospective cross-sectional study.

View Article and Find Full Text PDF

Purpose/objective: Adjuvant whole breast radiotherapy and systemic therapy are part of the current evidence-based treatment protocols for early breast cancer, after breast-conserving surgery. Numerous randomized trials have investigated the therapeutic effects of partial breast irradiation (PBI) compared to whole breast irradiation (WBI), limiting the treated breast tissue. These trials were designed to achieve equal control of the disease with possible reduction in adverse events, improvements in cosmesis and quality of life (QoL).

View Article and Find Full Text PDF

In recent years, a number of new therapies have led to advances in the treatment of patients with advanced breast carcinoma. These substances are mainly CDK4/6 inhibitors and other substances that can overcome endocrine resistance, oral selective estrogen receptor degraders, antibody drug conjugates (ADCs), and PARP inhibitors. This review summarizes and evaluates the latest study results that have been published in recent months.

View Article and Find Full Text PDF