Chemoradiation for organ preservation in the treatment of muscle-invasive bladder cancer.

Introduction: Standard therapy for muscle invasive bladder cancer includes neoadjuvant chemotherapy followed by radical cystectomy with urinary diversion. Three decades of interest in primary radiation and chemotherapy for bladder preservation have yielded mature that deserve closer examination.

Methods: We reviewed the literature with an emphasis on outcomes from major clinical trials and prospective studies, while highlighting important aspects of effective treatment delivery and unanswered questions surrounding this approach.

Influence of age on the effectiveness of PCV2 vaccination in piglets with high levels of maternally derived antibodies.

Two field studies were conducted to investigate the influence of age on the efficacy of vaccination against Porcine Circovirus Diseases (PCVD) in animals with high levels of maternally derived antibodies (MDA). A total of 416 piglets (Study 1) and 600 piglets (Study 2) were randomly allocated to one of three groups. Two groups in each study received a single dose of a PCV2 subunit vaccine, one group at 1 week old and the other at 3 weeks of age.

Phase 1 trial of neoadjuvant radiation therapy before prostatectomy for high-risk prostate cancer.

Purpose: To evaluate, in a phase 1 study, the safety of neoadjuvant whole-pelvis radiation therapy (RT) administered immediately before radical prostatectomy in men with high-risk prostate cancer.

Methods And Materials: Twelve men enrolled and completed a phase 1 single-institution trial between 2006 and 2010. Eligibility required a previously untreated diagnosis of localized but high-risk prostate cancer.

Neoadjuvant and adjuvant chemotherapy approaches for invasive bladder cancer.

Deeply invasive bladder cancer, representing approximately 20% of incident cases, is cured by radical cystectomy or radiotherapy in less than 50% of cases. In an effort to improve cure rates, based on objective response rates in metastatic disease of 40%-70% from combination chemotherapy regimens, systemic chemotherapy has been incorporated into programs of definitive treatment for this disease. Several randomized trials and a meta-analysis have confirmed a survival benefit from neoadjuvant chemotherapy followed by definitive local treatment, reflecting both median survival figures and cure rates.

Two-step transurethral surgery of the prostate and permanent implant brachytherapy for patients with lower urinary tract symptoms and low- to intermediate-risk prostate cancer.

Purpose: Prostate brachytherapy is an increasingly used treatment option for low- to intermediate-risk prostate cancer (PCa). However, patients with preexisting lower urinary tract symptoms (LUTS) and PCa, who would otherwise be good brachytherapy candidates, are often contraindicated because of the risk of postoperative urinary morbidity. We report our clinical experience with limited transurethral resection of the prostate (LTURP) and/or transurethral incision of the prostate (TUIP) months before brachytherapy to treat patients with LUTS and low- to intermediate-risk PCa.

German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups.

Background: To our knowledge, verum acupuncture has never been directly compared with sham acupuncture and guideline-based conventional therapy in patients with chronic low back pain.

Methods: A patient- and observer-blinded randomized controlled trial conducted in Germany involving 340 outpatient practices, including 1162 patients aged 18 to 86 years (mean +/- SD age, 50 +/- 15 years) with a history of chronic low back pain for a mean of 8 years. Patients underwent ten 30-minute sessions, generally 2 sessions per week, of verum acupuncture (n = 387) according to principles of traditional Chinese medicine; sham acupuncture (n = 387) consisting of superficial needling at nonacupuncture points; or conventional therapy, a combination of drugs, physical therapy, and exercise (n = 388).

Concurrent carboplatin and paclitaxel with pelvic radiation therapy in the primary treatment of cervical cancer.

Objective: The objective of the study was to determine the feasibility of weekly carboplatin/paclitaxel with radiation therapy (RT) in the primary treatment of cervical cancer.

Study Design: Women diagnosed with stage IB-1 to stage IVA untreated primary cervical cancer were eligible. Carboplatin (area under the curve = 2.

Designing an acupuncture study: II. The nationwide, randomized, controlled German acupuncture trials on low-back pain and gonarthrosis.

Background: In the nationwide German Acupuncture Trials (GERAC), verum acupuncture, mirroring the Traditional Chinese Medicine (TCM) acupuncture style, was tested against sham acupuncture and guideline standard therapy for the entities classified in the West as chronic low back pain (LBP) and gonarthrosis (GON).

Objective: The objective was to develop broadly consensual acupuncture and control protocols for the treatment of LBP and GON in the GERAC trials.

Methodology: Extensive literature study and consultation with acupuncture experts were consulted.

The German multicenter, randomized, partially blinded, prospective trial of acupuncture for chronic low-back pain: a preliminary report on the rationale and design of the trial.

Background: The efficacy of acupuncture treatment for chronic low-back pain has not been reliably proven because of a lack of good quality studies, leading to the necessity of developing the German Acupuncture Trial for Chronic Low-Back Pain (GERAC-cLBP) study.

Objective: The aim is to assess the effectiveness of traditional Chinese acupuncture for chronic low-back pain compared to sham acupuncture and with a conventional standard therapy.

Methods: This trial is a nationwide, multicenter, randomized, prospective, partially blinded study.

Extracorporeal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: a randomized controlled trial.

Context: Extracorporeal shock wave therapy (ESWT) has been used to treat calcific tendonitis of the shoulder, but trials of ESWT for this purpose have had methodological deficiencies and thus there is limited evidence for its effectiveness.

Objective: To determine whether fluoroscopy-guided ESWT improves function, reduces pain, and diminishes the size of calcific deposits in patients with chronic calcific tendonitis of the shoulder.

Design, Setting, And Participants: Double-blind, randomized, placebo-controlled trial conducted between February 1997 and March 2001 among 144 patients (of 164 screened) recruited from referring primary care physicians, orthopedic surgeons, and sports physicians in 7 orthopedic departments in Germany and Austria.

Extracorporeal shock wave therapy for plantar fasciitis: randomised controlled multicentre trial.

Objective: To determine the effectiveness of extracorporeal shock wave therapy compared with placebo in the treatment of chronic plantar fasciitis.

Design: Randomised, blinded, multicentre trial with parallel group design.

Setting: Nine hospitals and one outpatient clinic in Germany.

Concurrent carboplatin with pelvic radiation therapy in the primary treatment of cervix cancer.

Objectives: The objectives were to determine the acute toxicities of concurrent carboplatin and radiation therapy in the primary treatment of cervix cancer and to ascertain the antitumor activity of this regimen.

Methods: Patients with stage IB-1 to IVA untreated primary cervix cancers were eligible for enrollment into this study. Carboplatin was administered on a weekly basis with external radiation therapy (ERT).

Unchanged c-Fos expression after extracorporeal shock wave therapy: an experimental investigation in rats.

Background: Despite the extensive use of extracorporeal shock wave therapy (ESWT) in the therapy of chronic tendopathies, the biological mechanisms of its antinociceptive effects are still unclear.

Methods: In this study we addressed the question of whether the clinically described, long-lasting effect of ESWT is mediated by changes in the activity of spinal cord neurones. As a marker for neuronal activity which is also able to interfere with the molecular expression pattern of neurones, the expression of the inducible transcription factor c-Fos was analysed in the animal model of the rat.

[The effectiveness of radiation treatment in comparison with extracorporeal shockwave therapy (ESWT) in supraspinatus tendon syndrome].

Background And Aim: Supraspinatus tendinitis is usually treated by antiinflammatoric drugs, local injections, physiotherapy or low-dose irradiation. A novel approach is the use of Extracorporeal Shock Wave Therapy (ESWT) if conservative therapies have failed. So far there has been no controlled study comparing the effectiveness of ESWT with an established conservative method of therapy such as X-ray stimulation radiotherapy.

Exact focusing of extracorporeal shock wave therapy for calcifying tendinopathy.

A controlled prospective randomized study was designed to analyze the effect of extracorporeal shock wave therapy on calcifying tendinopathy of the shoulder focused on the calcified area or the origin of the supraspinatus tendon. Fifty patients were included in the study and were treated with a Storz Minilith Sl-1 shock wave generator. The first group of patients received 4000 impulses (positive energy flux density, 0.

No influence of low-energy extracorporeal shock wave therapy (ESWT) on spinal nociceptive systems.

The analgesic effects of high-energy extracorporeal shock wave therapy (ESWT) were discovered by chance during its application for urolithiasis and for bone pseudarthrosis. Despite the extensive use of ESWT, the mechanisms of its antinociceptive effects are still unclear. A gate control mechanism and other antinociceptive mechanisms have been postulated.