VMAT techniques for lymph node-positive left sided breast cancer.

Purpose: To investigate the plan quality of two different volumetric modulated arc therapy (VMAT) techniques for lymph node-positive left-sided breast cancer.

Methods: Two VMAT plans were generated for 10 lymph node-positive left-sided breast cancer patients: one plan using one single segment of a full rotation, typically an arc segment of 230° (1s-VMAT); and a second plan consisting of 2 small tangential arc segments of about 50° (2s-VMAT). For plan comparison, various dose and dose volume metrics (Dmean, D98%, D2% for target volumes, D2%, Dmean and Vx% for organs at risk (OAR)) were evaluated.

Neurosurgical treatment strategies in childhood craniopharyngiomas: is less more?

Objective: Craniopharyngiomas in children are typically present in combination with heterogeneous clinical and neuroradiological findings. It has remained highly challenging to choose the optimal treatment strategy with regard to local tumor control and clinical outcome. Here, we analyze different treatment methods and evaluate the results.

Secular trends in pediatric bloodstream infections over a 20-year period at a tertiary care hospital in Germany.

Objective: Over the last 20 years, a number of medical innovations with impact on the incidence of bacterial and fungal bloodstream infections (BSIs) in children have been developed and implemented. Although appropriate empirical antimicrobial therapy is a prerequisite to the successful treatment of BSIs, to date, epidemiological data on long-term microbiological trends in BSIs of hospitalized children have not been available.

Methods: Two cohorts of pediatric patients who were hospitalized in a single-center tertiary care hospital in Germany over a 20-year time span (period A from 1985 to 1995 vs.

Religious belief as a coping strategy: an explorative trial in patients irradiated for head-and-neck cancer.

Purpose: To explore the role of religious belief in coping with disease symptoms and treatment-related side effects in patients with head-and-neck cancer under radiotherapy.

Patients And Methods: Prospectively collected data were used with a cohort of head-and-neck cancer patients treated by radiotherapy and epoetin beta or placebo within a double-blind multicenter trial. All patients were divided into believers and nonbelievers.

Anemia and long-term outcome in adjuvant and neoadjuvant radiochemotherapy of stage II and III rectal adenocarcinoma: the Freiburg experience (1989-2002).

Aim: To evaluate the long-term outcome of standard 5-FU based adjuvant or neoadjuvant radiochemotherapy and to identify the predictive factors, especially anemia before and after radiotherapy as well as hemoglobin increase or decrease during radiotherapy.

Methods: Two hundred and eighty-six patients with Union International Contre Cancer (UICC) stage II and III rectal adenocarcinomas, who underwent resection by conventional surgical techniques (low anterior or abdominoperineal resection), received either postoperative (n=233) or preoperative (n=53) radiochemotherapy from January 1989 until July 2002. Overall survival (OAS), cancer-specific survival (CSS), disease-free survival (DFS), local-relapse-free (LRS) and distant-relapse-free survival (DRS) were evaluated using Kaplan-Meier, Log-rank test and Cox's proportional hazards as statistical methods.

Gastrointestinal cancer web sites: how do they address patients' concerns?

Background: We studied the quality of web sites containing information on gastrointestinal cancer, focusing on the way these web sites dealt with the special concerns of these patients.

Materials And Methods: Searching the Internet for German-language gastroenterological cancer web sites, we collected 9,947 web pages from 14 search engines. Evaluation was done with a 36-item questionnaire.

Spectrophotometric skin measurements correlate with EORTC/RTOG-common toxicity criteria.

Purpose: It was investigated whether the elementary EORTC/RTOG-CTC score (Common Toxicity Criteria) for radiotherapy skin reactions correlates with spectrophotometric measurements of the skin color. PATIENTS, MATERIAL, AND METHODS: In 41 patients irradiated for unilateral breast cancer the regular scoring by CTC was done during radiotherapy. In parallel, a total of 4,920 spectrophotometric measurements to determine the skin color were performed at baseline, at the beginning of radiotherapy, and at 20, 40 and 60 Gy.

Is older age associated with a worse prognosis due to different patterns of care? A long-term study of 1346 patients with glioblastomas or brain metastases.

Background: The objective of this study was to find out whether the worse prognosis of older patients with primary or metastatic brain tumors can be explained by different patterns of care compared with younger patients.

Methods: A data base that included 430 patients with glioblastomas and 916 patients with brain metastases who underwent radiotherapy at the author's hospital between 1980 and 2000 was analyzed. Patterns of care were compared for different age groups using the chi-square test.

Patients with brain metastases from gastrointestinal tract cancer treated with whole brain radiation therapy: prognostic factors and survival.

Aim: To identify the prognostic factors with regard to survival for patients with brain metastasis from primary tumors of the gastrointestinal tract.

Methods: Nine hundred and sixteen patients with brain metastases, treated with whole brain radiation therapy (WBRT) between January 1985 and December 2000 at the Department of Radiation Oncology, University Hospital Freiburg, were analyzed retrospectively.

Results: Fifty-seven patients presented with a primary tumor of the gastrointestinal tract (esophagus: n = 0, stomach: n = 10, colorectal: n = 47).

Moist skin care can diminish acute radiation-induced skin toxicity.

Background: Radiation treatment may induce acute skin reactions. There are several methods of managing them. Validity of these methods, however, is not sufficiently studied.

Brain metastases in patients with cancer of unknown primary.

Between January 1985 and December 2000, 916 patients with brain metastases were treated with whole brain radiation therapy (WBRT) at the Department of Radiotherapy, University Hospital Freiburg. In 47 patients, a primary tumor could not be identified (cancer of unknown primary (CUP)). Sixteen patients had a solitary brain metastasis, 31 patients presented with multiple brain metastases.

Long-term survival in patients with brain metastases.

Purpose: The aims of this study are: (a) to determine long-term survival in patients with brain metastases who underwent whole brain radiation therapy; (b) to evaluate whether long-term survival can be predicted by the Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis (RPA); and (c) to review the literature on long-term survival.

Material And Methods: The records of 916 patients with brain metastases who underwent whole brain radiation therapy at our hospital from 1985 to 2000 were analyzed retrospectively.

Results: By July 2001, 891 patients had died.

Malignant germ cell tumors metastatic to the brain: a model for a curable neoplasm? The Freiburg experience and a review of the literature.

The aim of this study on malignant germ cell tumors metastasizing to the brain is (a) to report our institutional experience, (b) to present three patients surviving for more than seven years, and (c) to review the literature with regard to long-term survival. From 1985 to 2000, 916 consecutive patients were treated with whole brain radiation therapy for brain metastases at our hospital. Eleven patients had cerebral lesions from histologically proven malignant germ cell tumors.

Patients with brain metastases: hope for recursive partitioning analysis (RPA) class 3.

Purpose: The objectives of the present study were (a) to validate the prognostic classification derived from recursive partitioning analysis (RPA) of the Radiation Therapy Oncology Group (RTOG); (b) to identify prognostic factors in class 3; (c) to examine the impact of treatment related variables on the prognosis in class 3.

Patients And Methods: Nine hundred and sixteen patients with brain metastases had resection and whole brain radiotherapy (WBRT, n = 257) or WBRT alone (n = 659) at our institution from 1985 to 2000. Patients were grouped into RPA classes 1, 2, and 3 (n = 67, 441, and 408, respectively).